Hemodialysis-Related Bioincompatibility and Adhesion Molecules

Dhondt, Annemieke; Vanholder, Raymond; Lameire, Norbert

doi:10.1177/039139889802100903

Cited by 4 publications

(2 citation statements)

References 36 publications

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“…Subsequent research indicated that the leucopaenia was a consequence of pulmonary sequestration of the cells mediated by the contact of blood with the membrane surface (Craddock et al 1977). It is now well accepted that C3a, C5a, and the terminal complement complex (TCC) stimulate the expression of receptors on leucocytes, leading to aggregation and sequestration in the pulmonary microvasculature (Dhondt et al 1998). The desire to minimize these responses resulted in the modification of the classical cellobiose unit of the cellulose strands in which the OH groups are either replaced or the blood contacting surface is coated by materials such as poly-ethylene glycol (PEG) to minimize blood exposure to the hydroxyl groups on the surface (see Fig.…”

Section: Contemporary Issuesmentioning

confidence: 99%

Cellulose for medical applications: Past, present, and future

Hoenich

2006

BioRes

132

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Films and tubes manufactured from cellulose have historically been used in the treatment of renal failure, but their use for this purpose has declined in recent years in favour of films manufactured from synthetic material blends. As the clinical application of cellulose for dialysis declines, new applications for its use are emerging, of which the most promising appears to be the use of microbial cellulose synthesized by Acetobacter xylinum as a novel wound healing system and as a scaffold for tissue regeneration.

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Section: Contemporary Issuesmentioning

confidence: 99%

Cellulose for medical applications: Past, present, and future

Hoenich

2006

BioRes

132

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“…Several studies have shown that various eel! types can be activated in patients on hemodialysrs The activation of circulating blood cells such as platelets and leukocytes during dialysis leads 1(1 upregulation of adhesion molecules (8)(9) and to the production and/or release of many biologically active mediators (6, 10-1 I). The net effectoutcorne of all these complex phenomena is the presence in the patient's bloodstream of a multitude of activated cells and chemical mediators in the patient's bloodstream, which may be important factors responsible for bio(in)compatibility.…”

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confidence: 99%

Platelet-Leukocyte Interactions in Hemodialysis Patients: Culprit or Bystander?

Sirolli

Amoroso

Pietropaolo

et al. 2006

Int J Immunopathol Pharmacol

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The formation of circulating platelet-leukocyte complexes has been observed in a variety of conditions and may be pathophysiologically significant. Platelet-leukocyte interactions in fact facilitate metabolic cooperation and mutual activation, which may be of relevance in many biological processes including inflammation, atherogenesis and hemostasis. During hemodialysis procedure, the series of reactions that can occur upon blood contact with the foreign membrane surface may involve a variety of changes affecting almost every cellular and plasmatic component of the blood. This article reviews the evidence for abnormal interactions between circulating platelets and leukocytes in uremic patients undergoing maintenance hemodialysis and the pathophysiologic implications which may stem from such interactions.

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Biocompatibility and Functional Performance of a Polyethylene Glycol Acid-Grafted Cellulosic Membrane for Hemodialysis

et al. 2000

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In order to improve the biochemical reactivity of the cellulose polymer, which is mainly attributed to the presence of surface hydroxyl groups, derivatized cellulosic membranes have been engineered replacing or masking some or all of the hydroxyl groups in the manufacturing process of the membrane. The present study was set up to analyze both biocompatibility and functional performance of two different derivatized cellulosic membranes (cellulose diacetate; polyethylene glycol, PEG, acid-grafted cellulose) as compared to a synthetic membrane (polymethylmethacrylate, PMMA). Cellulose diacetate is prepared by substituting hydroxyl groups with acetyl groups; PEG cellulose is obtained by grafting PEG chains onto the cellulosic polymer with a smaller amount of substitution than cellulose diacetate. While the three dialyzers provided similar urea and creatinine removal, the dialyzer containing cellulose diacetate showed a reduced ability to remove 32-microglobulin compared to that containing PEG cellulose or PMMA. A transient reduction in leukocyte count was observed for both derivatized cellulosic membranes. The neutrophil and monocyte counts throughout the entire dialysis session showed a closer parallelism with the cellular expression of the adhesive receptor CD 15s (sialyl-Lewis x molecule) than with CD11b/CD18 expression. Platelet activation, as indicated by the percentage of cells expressing the activation markers CD62P (P-selectin) and CD63 (gp53), occurred with all membranes at 15 min of dialysis and also with PMMA at 30 min. An increased formation of platelet-neutrophil and platelet-monocyte coaggregates was found at 15 and 30 min during dialysis with cellulose diacetate and PMMA but not with PEG cellulose. Generally in concomitance with the increase in platelet-neutrophil coaggregates, an increased hydrogen peroxide production by neutrophils occurred. Our results indicate that derivatizing cellulose may represent a useful approach to improve the biocompatibility of the cellulose polymer, though some homeostatic reactions remain activated. Our results also indicate that there may be a great variability in the biocompatibility profile of derivatize cellulosic membranes which most likely stem from the different type of structural modification rather than from the degree of hydroxyl group replacement.

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Hemodialysis-Related Bioincompatibility and Adhesion Molecules

Cited by 4 publications

References 36 publications

Cellulose for medical applications: Past, present, and future

Cellulose for medical applications: Past, present, and future

Platelet-Leukocyte Interactions in Hemodialysis Patients: Culprit or Bystander?

Biocompatibility and Functional Performance of a Polyethylene Glycol Acid-Grafted Cellulosic Membrane for Hemodialysis

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