Haemodialysis Membranes Modulate Chronically the Production of TNF , IL1 and IL6

Abstract

As cytokines may play a role in the adverse effects of haemodialysis, TNF alpha, IL1 beta and IL6 were investigated before the haemodialysis session (chronic effect) and after 30 and 60 min (session effect). We found that haemodialysis exerts a chronic effect on cytokines but the type of haemodialysis membrane, Cuprophan or Hemophan, specifically influences each cytokine. Circulating levels of TNF and unstimulated production of TNF and IL1 by monocytes were increased in patients dialysed with Hemophan, whereas a greater LPS-stimulated production of TNF was observed in patients dialysed with Cuprophan. Both types of membrane induced a higher production of IL6 as compared to controls. The alternate use of Cuprophan and Hemophan demonstrated that the production of TNF and IL1 was dependent on the type of haemodialysis membrane. We also found that Cuprophan induced a reversible decrease of spontaneous and LPS-stimulated production of TNF, IL1 and IL6 during the haemodialysis session. Taken together, these results suggest that Hemophan induced a sustained production of cytokines whereas Cuprophan primed monocytes, probably through the activation of the complement pathway.

Production of Tumor Necrosis Factor Alpha and Hemodialysis

“…Our study confirms the findings of several other studies which have reported greater than normal T N Fa production by mononuclear cells pre-HD [9,11,[19][20][21], Some of these studies like ours found a further increase in spontaneous TN Fa production immediately post-HD with cellulosic (Cuprophan) but not synthetic dialysis membranes [9,21]. Also in agreement with our findings most studies did not find an increase in TN Fa production with LPS stimulation after HD compared to pre-HD [9,11,19], although in the study of Chollet-Martin et al [9] this depended on the type of dialysis membrane.…”

“…It has been shown that the pluripotent cytokine interleukin 1 (1 L-l) can be released after contact with dialysis membranes both in vitro [1][2][3] and in vivo [4,5]. Plasma levels of three proinflammatory cytokines IL-1, interleukin-6 (IL-6) and tumor ne crosis factor a (TNFa) have been reported to be increased in HD patients although there is controversy as to whether short-term changes occur during the HD procedure itself [4][5][6][7][8][9][10][11], This study was done to assess both the production of TN Fa by mononuclear cells from HD patients and the effect of the dialysis treatment itself on TN Fa production. Since endogenous serum factors such as complement and exogenous factors such as endotoxin fragments might cross Accepted ; September the HD membrane and contribute to TN Fa production, spontaneous TN Fa production by cells of HD patients was examined both in their own sera and in non-HD sera.…”

Increased Production of Tumor Necrosis Factor Activity by Hemodialysis but Not Peritoneal Dialysis Patients

“…We confirmed our previous observations as well as those of others [17][18][19] that both pre-and post-HD PBMC produced significantly more TN Fa activity than the PBMC of normal controls. In addi tion we found that PBMC from HD patients produced significantly more TN Fa than PBMC from uremic patients not on dialysis who had TN Fa activity similar to that of controls.…”

Cytokine Production in Haemodialysis

“…Similar results were obtained for TNF [102,103] and IL-6 [104,105]. An IL-6 production (related to beta-2-microglobulin release) was observed, by our group, both before and after dialysis treatment with cellulosic membranes, suggesting a chronic or prolonged PBMC stimulation [106].…”