Impact of Hemodialysis Membrane and Permeability on Neutrophil Transmigration in vitro

Abstract

Background/Aim: The impact of dialysis membrane permeability on neutrophil transmigration properties in vitro was examined in the present study. This issue has not been fully scrutinized before. Methods: We studied the capacity of neutrophils collected from a group of dialysis patients randomly treated with cuprophan, low- or high-flux polysulfone, to transmigrate in vitro through a membrane covered with fibronectin (a main constituent of the endothelial basement membrane). The hemodialysis-induced quantitative changes in expression of adhesion molecules were examined in parallel. Results: At the end of dialysis, neutrophils collected from patients treated with high-flux polysulfone dialyzers had a significantly higher transmigration index than neutrophils from patients treated with low-flux polysulfone membrane (p < 0.01) or cuprophan membrane (p < 0.01), and approached the level of transmigration observed in neutrophils collected from healthy controls. In the groups treated with low-flux polysulfone and cuprophan dialyzers, the transmigration capacity was significantly lower (p < 0.02) compared to neutrophils from healthy subjects. We also noted that differences between low- and high-flux polysulfone dialysis, in the context of transmigration properties, were not mirrored by changes in adhesion phenotype, which strengthens the view that there is no strict relationship between these two features. Conclusion: The study demonstrates that high-flux polysulfone dialysis, as opposed to low-flux polysulfone and cuprophan treatment, improves the transmigration properties of circulating neutrophils, despite similar effects on adhesion molecule phenotypes. A plausible mechanism is that potentially toxic middle range molecules that inhibit neutrophil migration are more efficiently eliminated during high-flux polysulfone dialysis, but this explanation requires further support.

The stress of birth enhances in vitro spontaneous and IL‐8‐induced neutrophil chemotaxis in the human newborn

“…The CD11b expression of neutrophils from newborns was not affected by the delivery stress and was lower compared with adults, as previously reported (26). The increased transmigration ability was not associated with a concomitant increase in CD11b expression, a finding in line with results from human adults (27).…”

Leukocyte Function in High-Flux Hemodialysis

“…In vitro activation with fMLP induced a significant increase in the expression of CD11b on monocytes and neutrophils in the peripheral circulation and at the sites of interstitial inflammation, both in patients on highflux hemodialysis/hemodiafiltration and healthy subjects. The preserved capacity of both monocytes and neutrophils to express CD11b at the sites of interstitial inflammation in patients on high-flux hemodialysis/hemodiafiltration, as shown by our findings, may have important biological consequences in terms of an adequate performance of leukocyte functions in which the CD11b molecule plays a key role (Thylen et al 1997;Moshfegh et al 2002). Extravasated neutrophils and monocytes from patients on high-flux hemodialysis/hemodiafiltration showed a maintained response to fMLP as a second inflammatory stimulus after extravasation.…”

“…The dialysis membrane permeability and flux are also of importance in determining the acute and chronic effects of hemodialysis on the inflammatory system. High-flux polysulfone dialysis, as opposed to low-flux polysulfone and cuprophane treatment, has been shown to improve the transmigration of circulating neutrophils (Moshfegh et al 2002). High-flux dialysis membranes decrease the levels of the two degranulation inhibitory proteins (angiogenin and complement factor D), which could contribute to the maintained respiratory burst and phagocytic capacity seen in patients on high-flux hemodialysis (Horl 2002).…”

Monocyte and Neutrophil Chemotactic Activity at the Site of Interstitial Inflammation in Patients on High-Flux Hemodialysis or Hemodiafiltration

“…The in vivo data in the present study are in line with our previously reported data on the impact of dialysis membrane permeability on neutrophil transmigration properties in vitro. In that study, we demonstrated that high-flux polysulfone dialysis, as opposed to low-flux polysulfone and cuprophan treatment, improves the transmigration properties of peripheral neutrophils [26] .…”