Release of Granulocyte Proteinases during Hemodialysis

Hörl, Walter H.; Jochum, Marianne; Heidland, A.; Fritz, Hans

doi:10.1159/000166713

Cited by 69 publications

(3 citation statements)

References 20 publications

(13 reference statements)

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“…Release of leukocyte enzymes in effect of HD coexists with impairment of some granulocyte functions, such as bacteria killing and chemotaxis [24, 25]. However, substances released from stimulated granulocytes have potent biological activities, which are normally expressed in inflammatory sites [7, 26, 27]. RNases, due to their ability to penetrate cellular membranes and to break down cellular RNA, may have a deleterious effect on patients’ cellular functions.…”

Section: Discussionmentioning

confidence: 99%

Effect of Hemodialysis on Acid Leukocyte-Type Ribonuclease, Alkaline Ribonuclease and Polymorphonuclear Elastase Serum Levels in Patients with End-Stage Renal Disease

Naskalski¹,

Kapusta²,

Fedak³

et al. 2009

Nephron Clin Pract

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Background: Low-molecular-weight proteins (LMWPs) are substances of molecular weights 10–35 kDa, which accumulate in plasma of patients with end-stage renal disease (ESRD) due to the abolishment of plasma renal filtration. LMWPs are considered as a separate group of uremic toxins. Aim: The influence of hemodialysis (HD) on the release of some LMWPs from leukocytes was assessed by comparing levels of serum pancreatic-type alkaline RNase and leukocyte-type acid RNase as well aspolymorphonuclear (PMN) elastase. Methods: The mentioned proteins were assayed in 58 ESRD patients on HD prior and after the dialysis session and compared with the results obtained from 36 healthy subjects. The levels of elastase and acid and alkaline RNase were correlated with HD parameters, residual diuresis, predialysis concentrations of serum creatinine, urea and albumin as well as pre- and postdialysis granulocyte count. Results: Changes in PMN elastase produced by the dialysis session positively correlate with changes in acid RNase levels (r = 0.3650; p = 0.0061), while there is no such correlation for alkaline RNase. There is a negative correlation between pre- and postdialysis differences in levels of acid and alkaline RNases (r = –0.3542; p = 0.008), indicating that HD induces liberation of a factor suppressing alkaline RNase. Levels of acid and alkaline RNase negatively correlate with residual diuresis, indicating its significance in control of LMWP accumulation (r = –0.3970; p = 0.0025; r = –0.2596; p = 0.0533, respectively). Conclusions: Dialysis treatment causes an increase in both acid leukocyte-type and alkaline pancreatic-type RNase activity in plasma. Dialysis-related increases in acid RNase activity correlate with the respective changes in PMN elastase, which suggests that leukocyte activation during dialysis contributes to an increase in plasma LMWPs.

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Section: Discussionmentioning

confidence: 99%

Effect of Hemodialysis on Acid Leukocyte-Type Ribonuclease, Alkaline Ribonuclease and Polymorphonuclear Elastase Serum Levels in Patients with End-Stage Renal Disease

Naskalski¹,

Kapusta²,

Fedak³

et al. 2009

Nephron Clin Pract

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“…In hemodialysis the release of PMN-granulocyte elastase is due to contact of blood cells to membrane surfaces resulting in so called frustrane phagocytosis. 6 Since in hollow fiber oxygenators, with a capillary surface of more than 5 m,Z the increase of complex concentrations is even lower than in membrane oxygenators, elastase release can not only be due to contact of blood cells to foreign surfaces. Chenoweth et al could show that oxygen/blood contact may result in granulocyte stimulation by activation of the complement system.…”

Section: Discussion _______________ _mentioning

confidence: 99%

“…In patients requiring chronic hemodialysis lesions or activation of polymorphnuclear (PMN) granulocytes are observed due to contact of blood components to dialyser membranes, resulting in release of the neutral protease elastase. 6 Plasma elastase is readily inactivated by the proteinase inhibitors alpha !-proteinase inhibitor (alpha 1-PI) andalpha-2-macroglobulin. 7 However, an imbalance of released elastase and inhibitor concentration may lead to proteolytic degradation of various plasma proteins.…”

Section: Introduction _____________ _mentioning

confidence: 99%

Granulocyte Elastase Release during Extracorporeal Oxygenation: Effects of Bubble, Membrane, and Hollow Fiber Oxygenators

Wolf,

Lo,

Zeplin

et al. 1986

J Extra Corpor Technol

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Activation or lesions of PMN-granulocytes among other effects result in release of proteases i.e., elastase (E). Plasma E is mainly inactivated by alpha 1-proteinase inhibitor (alpha 1-PI) by formation of E-alpha 1-PI complexes. However, E may be able to destroy plasma proteins (i.e., clotting factors, immunoglobulins, etc.) before complex formation occurs. The effects of extracorporeal oxygenators on blood cells were investigated in samples of 26 patients before, during and up to three days after extracorporeal circulation (ECC) and oxygenation in open heart surgery. Three types of oxygenators were compared in clinical use: bubble (A), membrane (B), and hollow fiber (C). A significant increase of E alpha 1-PI concentrations is observed during ECC. The extent of E release depends on time of ECC and on the type of extracorporeal oxygenator (E alpha 1-PI levels at the end of ECC: 1514 +/- 557 ng/ml −A, 842 +/ 480 ng/ml − B, 506 +/ 128 ng/ml −C). Complex levels increase further on and reach maxima 2h after the end of ECC. The increase of E in plasma is more pronounced than other hemolytic parameters. E-alphal-PI complex levels thus seem to be a sensitive indicator for leukocyte lesions and/or activation during extracorporeal oxygenation.

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