Variables Associated with the Assessment of Systemic Tumor Necrosis Factor Alpha Levels during Hemodialysis

Jörres, Achim; Froese, P.; Fischer, Ch.‐H.; Safak, H; Gahl, Gerhard M.; Müller, Christiane; Vienken, Jörg

doi:10.1177/039139889201501106

Cited by 3 publications

(3 citation statements)

References 8 publications

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“…There was no significant difference between the two membranes. Jorres et al [6] observed no significant rise in TNFa levels on either PS or CU membranes or the high inter and intra-individual variability was assigned to the nonstandardized sampling procedures. Rise in circulating TNFa during hemodialysis has been shown in various studies [12,18,19] while others have demonstrated the contrary.…”

Section: Discussionmentioning

confidence: 96%

“…Samples for IL-1b and TNFa were drawn during the use of a fresh dialyzer in all patients at 0, 15, 240 mt of the dialysis session from the arterial side of the dialysis circuit, plasma separated and stored at À80 C immediately. [6] During each dialysis session (total 240 dialysis sessions) intradialytic clinical symptoms were recorded in the study performa. Cytokine assays were done using ELISA kits (BioSource Int., Inc., USA).…”

Section: Methodsmentioning

confidence: 99%

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Effect of Membrane Composition on Cytokine Production and Clinical Symptoms During Hemodialysis: A Crossover Study

et al. 2003

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Section: Discussionmentioning

confidence: 96%

Section: Methodsmentioning

confidence: 99%

Effect of Membrane Composition on Cytokine Production and Clinical Symptoms During Hemodialysis: A Crossover Study

et al. 2003

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“…The process of dialysis is also known to cause increases in some cytokines such as TNF-a although changes induced by dialysis vary with the type of membranes used (Cavaillon et al, 1992;Jorres et al, 1992;Nakahama et al, 1992;Ward and Gordon, 1993;Canivet et al, 1994;Halwachs et al, 1994;Leeuwenberg et al, 1994;Pereira et al, 1994). This probably accounts for the higher TNF-a concentrations seen in the anephric patient before treatment with IL-2.…”

Section: Discussionmentioning

confidence: 99%

Treatment of metastatic renal cell carcinoma with subcutaneous interleukin 2: evidence for non-renal clearance of cytokines

Banks

Forbes²,

Hallam³

et al. 1997

Br J Cancer

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Summary The circulating cytokine concentrations following administration of subcutaneous recombinant interleukin 2 (IL-2) in combination with interferon a and 5-fluorouracil used to treat advanced renal cancer were studied. One patient was anephric and on dialysis, and seven had normal biochemical renal function, although five had undergone single nephrectomy. The pharmacokinetics of IL-2 and changes in IL-6 and tumour necrosis factor (TNF)-a were essentially similar in all patients including the anephric patient, irrespective of the periods of dialysis, although at some time points, IL-2 concentrations were slightly higher in the anephric patient than in the others. These results show that for subcutaneous administration of low-dose IL-2, renal clearance of IL-2 is not important. This contrasts with high-dose, intravenous IL-2 where blood concentrations are higher and renal clearance seems to occur, perhaps because of saturation of the non-renal mechanisms of clearance. The subcutaneous route is certainly preferred if IL-2 is used in anephric patients and in those with impaired renal function, and it may be generally preferred for most purposes.Keywords: interleukin 2; renal; anephric; cytokine; clearance; therapy The use of interleukin 2 (IL-2) as a biological anti-cancer therapy is based on its ability to activate and enhance the cytotoxic activity of T lymphocytes and to stimulate natural killer cell-and lymphokine-activated killer cell activity. These actions are probably mediated both directly and via secondary induction of a cascade of cytokines including tumour necrosis factor (TNF)-a and IL-6 (Whittington and Faulds 1993; Janssen et al, 1994). Multiple regimens with IL-2 have been developed, but progress has been hampered by the marked toxicity associated with many of the higher dose intravenous (i.v.) regimens employed, most notably a capillary leak syndrome (similar to that seen in patients with septic shock) manifest by hypotension, weight gain, acute renal failure and pulmonary oedema (Whittington and Faulds, 1993). Newer approaches using lower dose subcutaneous (s.c.) IL-2 have been promising with, for example, recent combination regimens producing objective responses with less accompanying toxicity in 30-40% of patients with metastatic renal cell carcinoma (Atzpodien et al, 1990;Atzpodien-et al, 1993;Joffe et al, 1996).An understanding of cytokine metabolism is important for ensuring a rational approach to the design of therapeutic strategies, particularly with regard to route of administration and dosage. The mechanism of clearance is an important consideration as IL-2, for example, may be administered to patients who have undergone a nephrectomy, occasionally bilateral nephrectomies, and IL-2 itself may cause renal dysfunction. The Correspondence to: RE Banks following i.v. administration is generally thought to be consistent with a two-compartment model with first-order elimination kinetics. In rodents, an initial rapid clearance with a half-life (t,2) of approximately 1-5 min is followed by ...

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Elevated levels of tumor necrosis factor alpha in postdialysis fatigue

Dreisbach,

Hendrickson,

Beezhold

et al. 1998

Int J Artif Organs

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Postdialysis fatigue (PDF) has been ascribed to excessive ultrafiltration and decline in osmolality during hemodialysis. We evaluated the potential role for the sommogenic cytokines, interleukin-1 beta (IL-1β) and tumor necrosis factor alpha (TNFα), in the genesis of PDF. Patients dialyzing with cuprophane membrane were assigned to PDF (N=25) and non-PDF (N=25) groups based on a fatigue index questionnaire. Pre- and postdialysis samples were obtained from 3 consecutive treatments and later assayed for serum levels of IL-1β and TNFα by ELISA. Our results show significant intradialytic elevation of TNFα in both non-PDF groups (non-PDF: pre- 3.36±0.80 pg/ml to post 3.75±0.88 pg/ml, p<0.04; PDF: pre- 5.95±0.80 pg/ml to post- 8.66±1.35 pg/ml, p<0.02). The degree of intradialytic augmentation was significantly greater for TNFα in the PDF group (46 ± 18% vs 11 ± 5%; p<0.03). There were no significant intradialytic changes in serum levels of IL-1β in either the PDF or non-PDF groups. There also were no significant differences in dialysis-related body weights, systolic blood pressures, or osmolalities. These findings suggest that TNFα may be involved in the pathogenesis of PDF. (Int J Artif Organs 1998; 21:83–6)

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Variables Associated with the Assessment of Systemic Tumor Necrosis Factor Alpha Levels during Hemodialysis

Cited by 3 publications

References 8 publications

Effect of Membrane Composition on Cytokine Production and Clinical Symptoms During Hemodialysis: A Crossover Study

Effect of Membrane Composition on Cytokine Production and Clinical Symptoms During Hemodialysis: A Crossover Study

Treatment of metastatic renal cell carcinoma with subcutaneous interleukin 2: evidence for non-renal clearance of cytokines

Elevated levels of tumor necrosis factor alpha in postdialysis fatigue

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