Mechanisms Involved in Hypersensitivity Reactions to Polysulfone Hemodialysis Membranes

Rodríguez-Sanz, Aranzazu; Sánchez-Villanueva, Rafael; Domínguez‐Ortega, Javier; Fiandor, Ana-María; Ruiz, María-Paz; Trocoli, Filomena; Díaz-Tejeiro, Rafael; Cadenillas, Carlos; González, Elena; Martínez, Virginia; López-Trascasa, Margarita; Quirce, Santiago; Selgas, Rafael; Bellón, Teresa

doi:10.1111/aor.12954

Cited by 17 publications

(12 citation statements)

References 33 publications

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“…An ex-vivo model of HD was used as previously described ( 18 ). In brief, a closed circuit was assembled using a pediatric polysulfone hollow-fiber dialyzer (FX paed; Fresenius Care, Germany) and blood lines (SN-Set ONLINEplus BVM 5008-R, Fresenius Care, Germany).…”

Section: Methodsmentioning

confidence: 99%

Intradialytic Complement Activation Precedes the Development of Cardiovascular Events in Hemodialysis Patients

et al. 2018

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Background: Hemodialysis (HD) is a life-saving treatment for patients with end stage renal disease. However, HD patients have markedly increased rates of cardiovascular morbidity and mortality. Previously, a link between the complement system and cardiovascular events (CV-events) has been reported. In HD, systemic complement activation occurs due to blood-to-membrane interaction. We hypothesize that HD-induced complement activation together with inflammation and thrombosis are involved in the development of CV-events in these patients.Methods: HD patients were followed for the occurrence of CV-events during a maximum follow-up of 45 months. Plasma samples were collected from 55 patients at different time points during one HD session prior to follow-up. Plasma levels of mannose-binding lectin, properdin and C3d/C3 ratios were assessed by ELISA. In addition, levels of von Willebrand factor, TNF-α and IL-6/IL-10 ratios were determined. An ex-vivo model of HD was used to assess the effect of complement inhibition.Results: During median follow-up of 32 months, 17 participants developed CV-events. In the CV-event group, the C3d/C3-ratio sharply increased 30 min after the start of the HD session, while in the event-free group the ratio did not increase. In accordance, HD patients that developed a CV-event also had a sustained higher IL-6/IL-10-ratio during the first 60 min of the HD session, followed by a greater rise in TNF-α levels and von Willebrand factor at the end of the session. In the ex-vivo HD model, we found that complement activation contributed to the induction of TNF-α levels, IL-6/IL-10-ratio and levels of von Willebrand factor.Conclusions: In conclusion, these findings suggest that early intradialytic complement activation predominantly occurred in HD patients who develop a CV-event during follow-up. In addition, in these patients complement activation was accompanied by a pro-inflammatory and pro-thrombotic response. Experimental complement inhibition revealed that this reaction is secondary to complement activation. Therefore, our data suggests that HD-induced complement, inflammation and coagulation are involved in the increased CV risk of HD patients.

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Section: Methodsmentioning

confidence: 99%

Intradialytic Complement Activation Precedes the Development of Cardiovascular Events in Hemodialysis Patients

et al. 2018

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“…Der Verdacht besteht meist nicht bei einer klaren Anaphylaxie, sondern bei "unerklärten" Blutdruckabfällen, Haarausfall, Juckreiz und multikausalen Problemen (gemischte und Typ-4-Symptomatik). Deshalb ist es nötig, ähnlich wie bei der EO-Hypersensitivität auch PS-Tests zu nutzen, welche die zelluläre PS-Hypersensitivität bestätigen [43]. Nach den ersten Ergebnissen eines lymphozytären in vitro Provokationstest auf PS wurde eine in vitro Positivitätsrate von ca.…”

Section: Sympathikusaktivierung An Der Hämodialyseunclassified

Hämodialyse

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2020

Dialyse aktuell

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ZUSAMMENFASSUNGDie Wahl des Dialyseverfahrens erfolgt auf der Basis eines umfassenden Aufklärungsgesprächs zwischen Arzt und Patienten über die individuellen Merkmale der einzelnen Verfahren und ihrer Eignung für den Patienten. Das medizinisch beste Nierenersatzverfahren ist die Nierentransplantation, die aus verschiedenen Gründen jedoch nicht immer durchgeführt werden kann. Zwischen den beiden apparativen Dialyseverfahren Hämo- (HD) und Peritonealdialyse (PD) gibt es keine größeren, evidenzgesicherten Unterschiede bzgl. Morbidität und Mortalität, sodass hier neben einigen Ein- und Ausschlusskriterien die Patientenpriorität berücksichtigt werden muss. Zu den Patientenmerkmalen und -wünschen gehören die Auswirkung auf die Alltagsgestaltung, Berücksichtigung der Restdiurese und evtl. seltene Ausschlussmerkmale bei der Zugangswahl. Da die PD in den ersten Jahren nach Dialysestart einen evtl. Mortalitätsvorteil bieten könnte, macht es bei voraussichtlich langer Dialyseabhängigkeit deshalb Sinn, eine „Nierenersatzkarriere“ mit der PD zu beginnen und HD-Verfahren erst später zu nutzen.

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“…Rodríguez‐Sanz et al of Hospital La Paz Health Research Institute, Madrid, Spain investigated the mechanisms involved in polysulfone (PS) HD membrane hypersensitivity. Basophil and T cell activation, as well as higher serum tryptase levels were detected in acute‐phase samples compared with basal levels in two patients with systemic reactions to PS‐based membranes.…”

Section: Renal Supportmentioning

confidence: 99%

Artificial Organs 2017: A Year in Review

Malchesky¹

2018

Artificial Organs

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In this Editor's Review, articles published in 2017 are organized by category and summarized. We provide a brief reflection of the research and progress in artificial organs intended to advance and better human life while providing insight for continued application of these technologies and methods. Artificial Organs continues in the original mission of its founders "to foster communications in the field of artificial organs on an international level." Artificial Organs continues to publish developments and clinical applications of artificial organ technologies in this broad and expanding field of organ Replacement, Recovery, and Regeneration from all over the world. Peer-reviewed Special Issues this year included contributions from the 12th International Conference on Pediatric Mechanical Circulatory Support Systems and Pediatric Cardiopulmonary Perfusion edited by Dr. Akif Undar, Artificial Oxygen Carriers edited by Drs. Akira Kawaguchi and Jan Simoni, the 24th Congress of the International Society for Mechanical Circulatory Support edited by Dr. Toru Masuzawa, Challenges in the Field of Biomedical Devices: A Multidisciplinary Perspective edited by Dr. Vincenzo Piemonte and colleagues and Functional Electrical Stimulation edited by Dr. Winfried Mayr and colleagues. We take this time also to express our gratitude to our authors for offering their work to this journal. We offer our very special thanks to our reviewers who give so generously of time and expertise to review, critique, and especially provide meaningful suggestions to the author's work whether eventually accepted or rejected. Without these excellent and dedicated reviewers the quality expected from such a journal could not be possible. We also express our special thanks to our Publisher, John Wiley & Sons for their expert attention and support in the production and marketing of Artificial Organs. We look forward to reporting further advances in the coming years.

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Mechanisms Involved in Hypersensitivity Reactions to Polysulfone Hemodialysis Membranes

Cited by 17 publications

References 33 publications

Intradialytic Complement Activation Precedes the Development of Cardiovascular Events in Hemodialysis Patients

Intradialytic Complement Activation Precedes the Development of Cardiovascular Events in Hemodialysis Patients

Hämodialyse

Artificial Organs 2017: A Year in Review

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