Thylén P, Fernvik E, Haegerstrand A, Lundahl J, Jacobson S H
Department of Medicine, Karolinska Hospital, Stockholm, Sweden.
Am J Kidney Dis. 1997 Jan;29(1):78-85. doi: 10.1016/s0272-6386(97)90011-1.
In patients on hemodialysis, the sequences of events required for adhesion molecule-mediated adherence of monocytes and granulocytes to endothelial cells are pathophysiologically disrupted because activation of the cells with subsequent alterations in adhesion molecule phenotypes takes place in the extracorporeal circuit far away from the respective endothelial cell ligand. As a consequence, the host defense to infections may be affected. We analyzed the expression of CD62L and CD11b/CD18 on monocytes and granulocytes and the adherence of these cells, collected before, during, and after cuprophan hemodialysis, to resting and interleukin-1 beta (IL-1 beta)-stimulated adult human saphenous vein endothelial cells (HSVECs). Monocytes collected before dialysis adhered more avidly to HSVECs than did granulocytes. Adherence of both cell types increased to IL-1 beta-stimulated HSVECs (P < 0.05). Granulocytes obtained at 180 minutes adhered less to resting HSVECs than granulocytes harvested before hemodialysis (P < 0.05), despite an increase in CD11b/CD18 expression. To study if serum factors inhibiting adherence accumulate during hemodialysis, we incubated leukocytes harvested before hemodialysis in the same patients' serum collected before, during, and after dialysis. Serum collected at 180 minutes of cuprophan hemodialysis exerted inhibitory effects on both monocyte and granulocyte adhesion to HSVECs (P < 0.05). By contrast, serum collected during polysulfone hemodialysis of the same patients did not have any significant impact on the adherence of inflammatory cells to HSVECs. These findings contribute to an increased understanding of the factors involved in the impaired immune response observed in dialysis patients.
在接受血液透析的患者中，黏附分子介导的单核细胞和粒细胞与内皮细胞黏附所需的一系列事件在病理生理学上受到破坏，因为细胞激活以及随后黏附分子表型的改变发生在远离相应内皮细胞配体的体外循环中。因此，宿主对感染的防御可能会受到影响。我们分析了铜仿膜血液透析前、透析中和透析后收集的单核细胞和粒细胞上CD62L和CD11b/CD18的表达，以及这些细胞对静息和白细胞介素-1β（IL-1β）刺激的成人隐静脉内皮细胞（HSVECs）的黏附情况。透析前收集的单核细胞比粒细胞更 avidly 地黏附于HSVECs。两种细胞类型对IL-1β刺激的HSVECs的黏附均增加（P < 0.05）。尽管CD11b/CD18表达增加，但在180分钟时获得的粒细胞与血液透析前收获的粒细胞相比，对静息HSVECs的黏附较少（P < 0.05）。为了研究血液透析过程中是否会积累抑制黏附的血清因子，我们将同一患者血液透析前收集的白细胞在透析前、透析中和透析后收集的血清中孵育。铜仿膜血液透析180分钟时收集的血清对单核细胞和粒细胞黏附于HSVECs均有抑制作用（P < 0.05）。相比之下，同一患者聚砜膜血液透析期间收集的血清对炎症细胞黏附于HSVECs没有任何显著影响。这些发现有助于加深对透析患者免疫反应受损所涉及因素的理解。
