SUMMARYIn peripheral blood the majority of circulating monocytes present a CD14 high CD162 (CD14 11 ) phenotype, while a subpopulation shows a CD14 low CD16 1 (CD14 1 CD16 1 ) surface expression. During haemodialysis (HD) using cellulosic membranes transient leukopenia occurs. In contrast, synthetic biocompatible membranes do not induce this effect. We compared the sequestration kinetics for the CD14 1 CD16 1 and CD14 11 monocyte subsets during haemodialysis using biocompatible dialysers. Significant monocytopenia, as measured by the leucocyte count, occurred only during the first 30 min. However, remarkable differences were observed between the different monocyte subsets. CD14 11 monocyte numbers dropped to 77^13% of the predialysis level after 15 min, increasing to $ 93% after 60 min. In contrast, the CD14 1 CD16 1 subset decreased to 33^15% at 30 min and remained suppressed for the course of dialysis (67^11% at 240 min). Approximately 6 h after the end of HD the CD14 1 CD16 1 cells returned to basal levels. Interestingly, the CD14 1 CD16 1 monocytes did not show rebound monocytosis while a slight monocytosis of CD14 11 monocytes was occasionally observed during HD. A decline in CD11c surface density paralleled the sequestration of CD14 1 CD16 1 monocytes. Basal surface densities of important adhesion receptors differed significantly between the CD14 1 CD16 1 and CD14 11 subsets. In conclusion, during HD the CD14 1 CD16 1 subset revealed different sequestration kinetics, with a more pronounced and longer disappearance from the blood circulation, compared with CD14 11 monocytes. This sequestration kinetics may be due to a distinct surface expression of major adhesion receptors which facilitate leucocyte±leucocyte, as well as leucocyte±endothelial, interactions.
In hypertriglyceridaemic HD patients, dalteparin improved metabolism of TG-rich lipoproteins, increased buoyant LDL and decreased potentially atherogenic dense LDL. Preservation of lipoprotein lipase by LMW heparin may be a possible mechanism to explain our findings.
The association of membranoproliferative glomerulonephritis (MPGN) with Lyme borreliosis has only been reported for the C1q-negative subtype. A 64-year-old male presenting with rising creatinine, nephrotic syndrome and monoarthritis few months after a tick bite was noted to have mixed cryoglobulinaemia, a positive borrelia western blot and ‘full-house’ pattern MPGN with interstitial granuloma. Findings resolved with prednisolone and doxycyclin therapy. The histology is consistent with MPGN secondary to cryoglobulinaemia, which has most likely been caused by borrelia infection. ‘Full-house’ pattern MPGN may result from Lyme borreliosis through cryoglobulinaemia and may be treated successfully with the appropriate antibiotic therapy.
A method to monitor contraction of isolated myocytes by transmicroscopic photometry is illustrated. Two photodiodes are mounted inside an inverse microscope used for visual control of a cell. Illumination of one diode varies in proportion to changes in cell length. The contraction signal is amplified in a comparator circuit. Spatial resolution of the device is in the order of 1 micron which corresponds to about 5% of cell shortening in the fully activated state of contraction. The method was tested on isolated myocytes from guinea-pig ventricle. Optical records of contraction in response to action potentials or during voltage clamp compare well with the contractile behavior of multicellular preparations.
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