Leukotriene B&lt;sub&gt;4&lt;/sub&gt; and Tumor Necrosis Factor Release from Leukocytes: Effect of Peritoneal Dialysate

Jörres, Achim; Jörres, Dinah; Gahl, Gerhard M.; Kessel, Michael; Müller, Christian; Köttgen, Eckari; Serke, Stefan; Schulz, E.; Mahiout, A

doi:10.1159/000186436

Cited by 74 publications

(33 citation statements)

References 9 publications

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“…The finding that CAPD PBMC under certain conditions pro duced significantly less TN Fa activity than normal PBMC may be due, at least in part, to the influence of the dialysate which has been shown to inhibit TN Fa production by normal PBMC [35]. We are currently measuring IL-6 pro duction and serum levels in our different patient groups.…”

Section: Discussionmentioning

confidence: 97%

Increased Production of Tumor Necrosis Factor Activity by Hemodialysis but Not Peritoneal Dialysis Patients

McKenna

Macdonald²,

Bernstein³

et al. 1994

Nephron

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The production of tumor necrosis factor alpha (TNFα) activity by peripheral blood mononuclear cells (PBMC) was determined in uremic patients on chronic hemodialysis (HD; n = 27), continuous ambulatory peritoneal dialysis (CAPD; n = 19), and in patients with chronic renal failure who were not yet on dialysis (CRF-ND; n = 18). In the HD group blood was taken immediately prior to and immediately following an HD session utilizing a cellulose acetate dialyzer. Post-HD PBMC spontaneously (i.e. in serum free media) produced significantly more TNFα activity than the PB MC of all other patient groups as well as those of the normal controls (n = 41) (p < 0.003). Post-HD PBMC produced significantly more TNFα activity than pre-HD PBMC both spontaneously and in the presence of nonuremic sera (p < 0.003). PBMC prior to HD also produced significantly more TNFα activity than CAPD PBMC and normal PBMC in the presence of autologous heat inactivated sera (p < 0.03). Under some culture conditions (i.e. in the presence of nonuremic sera) normal PBMC produced significantly (p < 0.003) more TNFα activity than CAPD PBMC. Finally, a positive correlation was found between PBMC TNFα activity and age for HD patients (r = 0.7, p < 0.004) but not for CAPD or CRF-ND patients. These findings suggest that PBMC of HD but not CAPD or CRF-ND patients are chronically stimulated to produce TNFα activity. Differences in TNFα activity production by PBMC of HD and CAPD patients may determine, at least in part, the types of short- and long-term complications seen in these patient populations.

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Section: Discussionmentioning

confidence: 97%

Increased Production of Tumor Necrosis Factor Activity by Hemodialysis but Not Peritoneal Dialysis Patients

McKenna

Macdonald²,

Bernstein³

et al. 1994

Nephron

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“…Since the inhibitory capacity of the fluids appears to be related to low pH, high osmolality and high glucose con centrations present in conventional fluids [6,9], it might be expected that the equilibration of the dialysates which occurs in CAPD patients should lead to a significant reduction in such inhibitory effects. Such recovery of cell function in spent peritoneal dialysates has been shown with respect to the capacity for phagocytosis and respira tory burst activation which are significantly suppressed by effluent obtained after up to 3 h but not after overnight intraperitoneal dwell time [2,9].…”

Section: Discussionmentioning

confidence: 99%

“…FRG). This short incubation period was required in order to mimic the clinical time frame of peritoneal dialysis; the necessary endotoxin dosage for the short-time stimulation was chosen following dose response studies using endotoxin doses between 0.1 and 10 pg/ml [6]. The incubation was stopped by centrifugation (400?…”

Section: Incubation Proceduresmentioning

confidence: 99%

Inhibition of Cytokine Synthesis by Peritoneal Dialysate Persists throughout the CAPD Cycle

Jörres¹,

Topley

Steenweg

et al. 1992

Am J Nephrol

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The current study focused on the effect of continuous ambulatory peritoneal dialysis (CAPD) dialysate obtained following different intraperitoneal dwell periods on the release of interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNFa) from mononuclear leukocytes (PBMC). Aliquots of 5 X 10⁶/ml healthy peripheral PBMC were exposed to fresh or spent CAPD dialysate (10-240 min of intra-peritoneal dwell) and stimulated with Escherichia coli endotoxin (10 jxg/ml, 2 h). IL-6 and TNFa in cell supernatants were determined by specific enzyme immunoassays. Control PBMC in physiological buffer released 361 ± 70 pg/ml IL-6 and 717 ± 147 pg/ml TNFa (mean ± SEM, n = 8), whereas exposure to fresh dialysis fluids severely suppressed cytokine release from PBMC ( < 30 pg/ml IL-6 and < 15 pg/ml TNFa). A significant inhibition of IL-6 and TNFa release was also observed in PBMC exposed to spent dialysate. The inhibitory capacity of the spent fluids was pronounced with increasing intra-peritoneal dwell time (10 min: 183 ± 45 pg/ml IL-6 and 538 ± 109 pg/ml TNFa; 240 min: 26 ± 5 pg/ml IL-6 and 105 ± 30 pg/ml TNFa; mean ± SEM, n = 16). These data indicate that the impairment of cell responsiveness following exposure of PBMC to peritoneal dialysate is not restricted to the unused fluids, but is also observed following intra-peritoneal equilibration. Moreover, our findings suggest the presence of cytokine inhibitory factors in the peritoneal dialysate of CAPD patients which appear to accumulate in the peritoneal effluent during the CAPD cycle.

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“…Low pH in combination with lactate is also shown to inhibit production of IL-1, IL-6 and TNF-a by peripheral and peritoneal mononu clear cells [33][34][35][36]. These data suggest that cellular host defense is impaired early in the dialysis cycle as a result of pH-mediatcd 'stun ning' of resident phagocytes.…”

Section: Dialysate Ph and Phagocytic Cell Functionmentioning

confidence: 99%

Impact of Terminal Heat Sterilization on the Quality of Peritoneal Dialysis Solutions

Martis

Henderson²

1997

Blood Purif

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In order to meet the sterility requirements imposed by the various regulatory bodies around the world, peritoneal dialysis solutions are terminally heat-sterilized at an acid pH. There is growing concern that both acid pH and the glucose degradation products formed during terminal heat sterilization adversely affect the quality of the therapy provided to the end-stage renal failure patient on peritoneal dialysis. Acid pH and glucose degradation products are thought to contribute to impaired host defense and hence to increased risk of infection, loss of ultrafiltration, and peritoneal fibrosis. On the other hand, peritoneal dialysis solutions prepared by aseptic processing are devoid of in vitro cytotoxicity and hence are considered more biocompatible than heat-sterilized solutions. With new technologies permitting aseptic processing to achieve sterility assurance levels approaching solutions manufactured by terminal heat sterilization, it is possible to produce solutions that are more biocompatible than heat-sterilized products without increasing the risk of microbial contamination.

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Leukotriene B<sub>4</sub> and Tumor Necrosis Factor Release from Leukocytes: Effect of Peritoneal Dialysate

Cited by 74 publications

References 9 publications

Increased Production of Tumor Necrosis Factor Activity by Hemodialysis but Not Peritoneal Dialysis Patients

Increased Production of Tumor Necrosis Factor Activity by Hemodialysis but Not Peritoneal Dialysis Patients

Inhibition of Cytokine Synthesis by Peritoneal Dialysate Persists throughout the CAPD Cycle

Impact of Terminal Heat Sterilization on the Quality of Peritoneal Dialysis Solutions

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