Expression of [beta]2-microglobulin and c-fos mRNA: Is there an influence of high- or low-flux dialyzer membranes?

Expression of [beta]2 -microglobulin and c-fos mRNA: Is there an influence of high- or low-flux dialyzer membranes?BackgroundDialysis-related amyloidosis is an important complication of long-term hemodialysis (HD) therapy with several pathogenetic factors. One of them is the influence of the dialyzer membrane type on the synthesis of [beta]2 -microglobulin ([beta]2 m). In vitro results are controversial. Thus, the hypothesis of whether in vivo [beta]2 m generation is induced by the HD procedure and whether this induction depends on the type of the used dialyzer membrane should be tested. The aim of the present study was to investigate the influence of "biocompatible" high-flux versus "bioincompatible" low-flux HD on in vivo [beta]2 m generation as well as the induction of the early activation gene c-fos in peripheral blood cells.MethodsSix nondiabetic HD patients [mean age 46 (21 to 69) years; Kt/V > 1.2] were included in a randomized crossover study using either a low-flux (cellulosic/cuprophan) or a high-flux (polyamide) dialyzer membrane. At the end of a four-week run-in period for each membrane, whole blood samples were taken before, immediately at, and four hours after the end of the dialysis session. MRNA was extracted, and after transcription to cDNA, quantitative polymerase chain reaction was performed for the [beta]2 m gene, the early response gene c-fos, and the GAP-DH housekeeping gene.ResultsBased on the applied method for detection of specific mRNA, the results were given as ratio of [beta]2 m or c-fos cDNA per GAP-DH cDNA. General cell activation during HD was indicated by increasing mRNA expression of c-fos related to the time course of the dialysis session, whereas [beta]2 m did not change significantly. However, no difference was found when comparing the low-flux and the high-flux dialyzer membranes. Despite the evidence for activation of peripheral blood cells, as indicated by increasing c-fos message, no sign of [beta]2 m mRNA induction during HD procedure with different dialyzer membranes was seen.ConclusionsOur results suggest that there is post-transcriptional regulation of [beta]2 m generation and/or release as well as the influence of the dialyzer membrane type on post-translational processes, that is, advance glycation end products (AGE) or conformational modification of the [beta]2 m protein. Furthermore, our data demonstrate that gene expression patterns during dialysis and/or uremia are not homogenous and need to be investigated