Induction of IL-1 during hemodialysis: Transmembrane passage of intact endotoxins (LPS)

Induction of IL-1 during hemodialysis: Transmembrane passage of intact endotoxins (LPS). Circulating monocytes of patients undergoing chronic hemodialysis are triggered to produce interleukin-1 (IL-1) in vivo. Intradialytic induction of IL-1 is associated with complement activation in patients dialy...

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Bibliographic Details
Published in:Kidney international 1990-12, Vol.38 (6), p.1089-1094
Main Authors: Laude-Sharp, Maryline, Caroff, Martine, Simard, Laurent, Pusineri, Christian, Kazatchkine, Michel D., Haeffner-Cavaillon, Nicole
Format: Article
Language:English
Subjects:
550901 - Pathology- Tracer Techniques
Acrylic Resins
Acrylonitrile - analogs & derivatives
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
ANIMALS
ARTIFICIAL ORGANS
BACTERIA
BASIC BIOLOGICAL SCIENCES
Biocompatible Materials
Biological and medical sciences
BIOLOGICAL MATERIALS
BIOSYNTHESIS
BLOOD
BLOOD CELLS
BODY
BODY FLUIDS
CARBOHYDRATES
Cellulose - analogs & derivatives
DIALYSIS
Dialysis Solutions
DISEASES
Emergency and intensive care: renal failure. Dialysis management
GROWTH FACTORS
Humans
HYDROGEN COMPOUNDS
In Vitro Techniques
Intensive care medicine
Interleukin-1 - metabolism
ISOTOPE APPLICATIONS
KIDNEYS
LEUKOCYTES
Leukocytes, Mononuclear - metabolism
LIPIDS
LIPOPOLYSACCHARIDES
Lipopolysaccharides - pharmacokinetics
LYMPHOKINES
MAMMALS
MAN
MATERIALS
MECHANICAL KIDNEY
Medical sciences
MEDICAL SUPPLIES
MEMBRANE TRANSPORT
MEMBRANES
Membranes, Artificial
MICROORGANISMS
MITOGENS
MOLECULAR WEIGHT
MONOCYTES
Neisseria meningitidis
ORGANIC COMPOUNDS
ORGANS
PERMEABILITY
Polymers
POLYSACCHARIDES
PRIMATES
PROSTHESES
PROTEINS
PSEUDOMONAS
Renal Dialysis
SACCHARIDES
SEPARATION PROCESSES
Sulfones
SYNTHESIS
TRACER TECHNIQUES
Tritium
TRITIUM COMPOUNDS
UROGENITAL SYSTEM DISEASES
VERTEBRATES
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Summary:Induction of IL-1 during hemodialysis: Transmembrane passage of intact endotoxins (LPS). Circulating monocytes of patients undergoing chronic hemodialysis are triggered to produce interleukin-1 (IL-1) in vivo. Intradialytic induction of IL-1 is associated with complement activation in patients dialyzed with first-use cellulose membranes. Chronic stimulation of IL-1 production occurs because of an yet unidentified mechanism in patients dialyzed with high permeability membranes. The present study demonstrates that intact bacterial lipo-polysaccharide (LPS) molecules may cross cuprophan, AN69 and polysulfone membranes under in vitro conditions simulating in vivo hemodialysis. The experiments used purified LPS from Neisseria meningitidis and LPS from Pseudomonas testosteroni, a bacterial strain grown out from a clinically used dialysate. LPS were purified to homogeneity and radiolabeled. Transmembrane passage of 3H-labeled LPS was observed within the first five minutes of dialysis. A total of 0.1 to 1% of 3H-labeled LPS were recovered in the dialysate compartment after one hour of dialysis. High amounts of LPS, representing 40 to 70% of the amount originally present in the dialysate, were absorbed onto high permeability membranes. Low amounts of LPS were absorbed onto cuprophan membranes. The amount of LPS absorbed decreased with the concentration of LPS in the dialysate. LPS recovered from the blood compartment exhibited the same molecular weight as that used to contaminate the dialysate. Biochemically detectable transmembrane passage of LPS was not associated with that of material detectable using the limulus amebocyte lysate (LAL) assay. An IL-1-inducing activity was, however, detected in the blood compartment upon dialysis with high permeability membranes, as previously found by others with cuprophan membranes. These results provide a basis for the chronic induction of IL-1 production in patients dialyzed with high permeability membranes and for an enhancing mechanism of complement-dependent induction of IL-1 in patient dialyzed with cuprophan membranes. Our observations emphasize the importance of obtaining LPS-free dialysates to improve the biocompatibility of hemodialysis.
ISSN:0085-2538
1523-1755
DOI:10.1038/ki.1990.317