Is Steam Sterilization Really Making Any Difference in Dialysis-Induced Cytokine Release?

Aucella, Filippo; Tetta, Ciro; Tessore, V; Nitti, C. De; Vigilante, M.; Gatta, Gemma; Margaglione, Maurizio; Colaizzo, Donatella; Cappucci, Giuseppe; Modoni, Sergio; Stallone, C.

doi:10.1177/039139880202500904

Cited by 7 publications

(7 citation statements)

References 15 publications

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“…It is also possible that this effect is a specific one, each membrane showing its own profile. Indeed, the results of the present study about Cuprophan are quite different from that previously obtained by our group with low‐flux polysulphone (10) or SMC membrane (11), both showing a reduced release of mononuclear cytokines with steam sterilization. It is well known that a different absorption of inflammatory mediators on the membrane surface or a different capacity of activating a lymphocyte receptor (13) may be involved in a different cytokine release.…”

Section: Discussioncontrasting

confidence: 99%

“…Dialysis‐induced cytokine production has been linked to the adherence of mononuclear cells to the membrane, the generation of anaphylatoxins, and the bacterial contamination of the dialysate (5). Actually, very few studies have investigated the effect of the sterilization method on the biocompatibility (6–9) and especially the effect on cytokine release (10,11). On the contrary, sterilization may be involved either in hypersensitivity reactions such as ETO sterilization (2) or in alterations of the membrane characteristics such as structure and permeability (12).…”

Section: Discussionmentioning

confidence: 99%

“…In previous studies, we reported that steam and ETO sterilized low‐flux polysulphone membrane showed the same purification performances and the same low production rate of complement while steam sterilized membranes have better intradialytic eosinophil kinetics (6). We showed also a reduction of mononuclear cytokine production in hemodialysis patients treated with steam sterilized low‐flux polysulphone membrane (10) or synthetically modified cellulose (SMC) (11). Each membrane has its own structure and may be modified by the sterilization methods, so each membrane needs to be studied in this regard.…”

Section: Discussionmentioning

confidence: 99%

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Effects of Ethylene Oxide and Steam Sterilization on Dialysis‐Induced Cytokine Release by Cuprophan Membrane

Aucella¹,

Vigilante²,

Gatta³

et al. 2002

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The effects of sterilization modalities on dialysis-induced cytokine release are still unknown. To investigate these effects, 8 patients on chronic hemodialysis were enrolled for evaluating at different intervals interleukin-1beta (IL-1beta) and tumor necrosis factor-alpha (TNF-alpha) production (pg/ml/106). They were using a 1.3 m2 ethylene oxide (E3) or steam (E3S) sterilized Cuprophan membrane. The patients underwent a basal test with E3 (A1) and 2 following tests after 1 (B1) and 2 (B2) months of E3S treatment, respectively. Finally, the last test was performed 1 month after the switch to E3 (A2). Il-1beta predialysis release by mononuclear cells was 162 +/- 114 pg/ml/106 in A1, 185 +/- 129 pg/ml/106 in B1, and 226 +/- 138 pg/ml/106 in B2, then decreased to 123 +/- 134 in A2 (p < 0.07). Il-1beta postdialysis levels were 234 +/- 238 pg/ml/106 in A1, 429 +/- 285 pg/ml/106 (B1), and 438 +/- 473 pg/ml/106 (B2) with the steam membrane, decreasing to 204 +/- 134 pg/ml/106 in A2 (p < 0.01). TNF-alpha predialysis basal release (A1) was 826 +/- 817 pg/ml/106, 720 +/- 496 in B1, and 1079 +/- 515 pg/ml/106 in B2, and finally 680 +/- 588 pg/ml/106 in A2 (p < 0.03). In postdialysis TNF-alpha levels were 963 +/- 542 pg/ml/106 in A1, 1,226 +/- 541 pg/ml/106, and 1,183 +/- 776 in B1 and B2 respectively, and 388 +/- 297 pg/ml/106 in A2 (p < 0.003). Steam sterilization seems to induce a higher cytokine release by mononuclear cells when a Cuprophan membrane is used. This finding may be related to a less physiologic action of the steam in the case of Cuprophan membranes. Further studies are needed to clarify this hypothesis.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Effects of Ethylene Oxide and Steam Sterilization on Dialysis‐Induced Cytokine Release by Cuprophan Membrane

Aucella¹,

Vigilante²,

Gatta³

et al. 2002

Artificial Organs

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“…Meanwhile, alternative sterilization modes such as steam sterilization have been suggested [4,5]. In this study, we tried to check if the sterilization process really makes any difference in dialysis-induced genotoxicity.…”

Section: Introductionmentioning

confidence: 99%

Do Sterilization Processes Really Make Difference in Dialysis-Induced Genotoxicity?

Golli-Bennour¹,

Zaied²,

Bouaziz³

et al. 2017

World J Nephrol Urol

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The major problem associated with hemodialysis (HD) therapy is the choice of dialyzer membrane matters as well as the mode of sterilization required before utilization. In this context, we aimed to determine the effect of two sterilization processes (steam and gamma rays) on genotoxicity of polysulfone dialysis membranes. A 38-year-old man with end-stage renal disease and one age-matched healthy subject were enrolled in our study. We analyzed lipid peroxidation measured by serum malondialdehyde (MDA) formation and DNA fragmentation assessed by agarose gel electrophoresis and diphenylamine quantification. Our results clearly showed that there is a rising generation of MDA and DNA fragmentation in patient sera during HD session when compared to healthy subject data. This increase in MDA and DNA fragmentation amounts followed respectively the sterilization process. As classified from the more biocompatible one, the steam sterilized polysulfone dialyzer is the top ranked, followed by the gamma rays sterilized one. We concluded that using steam instead of gamma rays for sterilization may improve the biocompatibility of polysulfone dialyzer membranes.

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“…However, high energy irradiation carries the risk of membrane degradation, which might cause important and undesired changes in membrane properties, such as dimensional stability, mechanical resistance and hydraulic and diffusive permeability [5,6]. Meanwhile, alternative sterilization modes, such as steam sterilization have been suggested [7,8]. In this study, we tried to check if the steam sterilization process really makes a difference in dialysis-induced cytotoxicity, particularly oxidative damage.…”

Section: Introductionmentioning

confidence: 99%

Cytotoxic effects exerted by polyarylsulfone dialyser membranes depend on different sterilization processes

et al. 2009

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Polyarylsulfone group is one of the most important polymeric materials used in the biomedical field, due to its excellent properties, such as good thermal, chemical, and mechanical stability. There are three important polyarylsulfone polymers, all of which have excellent electrical properties: polysulfone (PSu), polyarylsulfone (PAS) and polyarylethersulfone (PAES). All these polymers have excellent creep, radiation and high temperature resistance. In this study, we aimed to determine the effect of three sterilization processes (steam, ethylene oxide and gamma rays) on cytotoxicity of polyarylsulfone dialysis membranes. Ten long-term dialysis patients and ten age-matched healthy controls were enrolled in our study. We analysed (1) serum effect on cultured endothelial cell viability using MTT assay and (2) lipid peroxidation assessed by serum malondialdehyde (MDA) formation at the beginning (T0), the middle (T2) and the end (T4) of haemodialysis (HD) session. Our results clearly showed that steam-sterilized membranes improve endothelial cell viability when compared to ethylene oxide or gamma rays-sterilized ones. Moreover, there is a increased generation of MDA in patients sera during HD session. The serum MDA concentration was about 3, 6 and 10 times higher, respectively, for steam, ethylene oxide and gamma rays sterilization procedures when compared to the MDA amount in healthy subject sera. We concluded that using steam instead of ethylene oxide or gamma rays for sterilization may improve the biocompatibility of polyarylsulfone membranes.

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Is Steam Sterilization Really Making Any Difference in Dialysis-Induced Cytokine Release?

Cited by 7 publications

References 15 publications

Effects of Ethylene Oxide and Steam Sterilization on Dialysis‐Induced Cytokine Release by Cuprophan Membrane

Effects of Ethylene Oxide and Steam Sterilization on Dialysis‐Induced Cytokine Release by Cuprophan Membrane

Do Sterilization Processes Really Make Difference in Dialysis-Induced Genotoxicity?

Cytotoxic effects exerted by polyarylsulfone dialyser membranes depend on different sterilization processes

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