Plasma Levels of Main Granulocyte Components during Hemodialysis: Effects of Immunosuppression

Abstract

Plasma levels of granulocyte lactoferrin, granulocyte myeloperoxidase and granulocyte elastase in complex with α_rproteinase inhibitor were investigated during hemodialysis in oliguric patients following cadaveric renal transplantation (CRT). The results were compared with those of patients undergoing regular hemodialysis treatment (RDT) using different membrane materials. In RDT patients, plasma lactoferrin levels increased from 61.9 ± 10.2 to 417.9 ± 96.7 using dialyzers made of cuprophane. Dialyzers made of polymethyl methacrylate induced an increase of lactoferrin from 166.6 ± 28.5 to 712.5 ± 165.9 and dialyzers made of polyacrylonitrile an increase from 122.6 ± 23.5 to 647.7 ± 203.6 ng/ml. In CRT patients, in contrast, plasma lactoferrin levels increased from 49.1 ± 10.9 to 199.6 ± 45.9 (cuprophane), from 30.1 ± 6.9 to 252.5 ± 46.9 (polymethyl methacrylate), and from 43.3 ± 9.1 to 174.2 ± 39.3 ng/ml (polyacrylonitrile). On the other hand, the plasma levels’ of myeloperoxidase and elastase in complex with αi-proteinase inhibitor increased comparably in both groups of patients. Our data suggest that immunosuppression might prevent degranulation of specific granules independently of the used dialyzer membrane material, whereas no effect was observed on two main components of azurophilic granules.

Active Inhibitory Effect of Nafamostat Mesylate against the Elevation of Plasma Myeloperoxidase during Hemodialysis

“…We observed that the concentration of plasma MPO rose rapidly after the start of HD and remained at high levels until the end of HD with heparin. A similar pattern of change in MPO levels during HD with heparin has been reported using an EIA with a polyclonal anti body [13][14][15].…”

“…Our data, and those of others [8,12,13], show that granulocyte activation with elevated plasma levels of PMN-elastase and leukocytopenia occurs in patients dur ing HD with heparin and a cuprophane dialysis mem brane. Elevation of several cell-derived factors during HD has also been reported [15]. We developed a monoclonal antibody against human MPO.…”

“…It has a molecular weight of approxi mately 150.000 and catalyzes the oxidation of chloride anion to yield hypochlorous acid in the presence of hydro gen peroxide produced by PMN during activation [2], PMN-elastase is a neutral proteinase also located in the Granulocyte activation with elevated plasma levels of PMN-elastase and complement activation occur during hemodialysis (HD) [6,7]. The intensity of this process during HD is determined by the type of dialysis mem brane used [8][9][10][11][12], There have been some reports of gran ulocyte activation with elevated MPO plasma levels dur ing HD [13][14][15]. We developed an enzyme immunoassay to measure MPO quantitatively by using a monoclonal antibody produced in our laboratory.…”

Ultrapure Dialysate Influences Serum Myeloperoxidase Levels and Lipid Metabolism

“…Previous studies have focused on determining which factors cause MPO release during HD-associated bioincompatibility (harmful effects induced by contact of blood with the dialysis membrane) or the association between anticoagulation regimen and MPO levels [23] . One study reported increased MPO levels in the first 15 min of dialysis with CP and polymethylmethacrylate membranes [24] . Another reported that immunoreactive plasma MPO levels increased after 15 min of HD and were almost three times greater with a regenerated cellulose membrane than a polysulfone membrane [25] .…”

Short-Term Administration of Colchicine to Haemodialysis Patients: Plasma Beta-2-Microglobulin and Phagocyte Oxidative Response

“…Colchicine, a potent anti-inflammatory agent, binds to tubulin, blocks mitosis, and inhibits a variety of the functions of PMN both in vivo and in vitro [10], Wysocki et al [7] demonstrated that colchicine administration to dialysis patients led to a lesser decrease of circulating PM N during the haemodialysis session and suggested in addition that this agent could prevent the haemodialysisinduced PMN degranulation. On the otherhand,it is well known that colchicine treatment may lead to an arrest of AA amyloidosis associated with familial Mediterranean fever.…”