Increased Binding of Beta-2-Microglobulin to Blood Cells in Dialysis Patients Treated with High-Flux Dialyzers Compared with Low-Flux Membranes Contributed to Reduced Beta-2-Microglobulin Concentrations: Results of a Cross-Over Study
Patients on long-term dialysis eventually develop amyloid deposits with beta2-microglobulin as a predominant component. Although several studies have suggested that high-flux membranes reduce beta2-microglobulin in plasma compared with low-flux dialyzers, the mechanisms underlying this observation a...
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| Veröffentlicht in: | Blood purification 2007, Vol.25 (5-6), p.432-440 |
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| creator | TRAUT, Mario HAUFE, Christoph C EISMANN, Ulrike DEPPISCH, Reinhold M STEIN, Günter WOLF, Gunter |
| description | Patients on long-term dialysis eventually develop amyloid deposits with beta2-microglobulin as a predominant component. Although several studies have suggested that high-flux membranes reduce beta2-microglobulin in plasma compared with low-flux dialyzers, the mechanisms underlying this observation are still discussed.
We revisited this important subject and measured beta2-microglobulin in the plasma of healthy individuals (n = 8), and patients undergoing hemodialysis (n = 20) who for assigned periods of time were either treated with a low-flux membrane (cuprophan) or high-flux (polyamide) dialyzer with an ELISA. The number of blood cells was determined by FACS. Beta2-microglobulin was also measured on the surface of granulocytes, lymphocytes, and monocytes before, directly after, and 4 h after hemodialysis. Expression of beta2-microglobulin, c-fos, tumor necrosis factor-alpha (TNF-alpha), and interleukin-1 mRNA was determined in whole blood samples with quantitative RT-PCR using an internal standard in parallel. In the second part of the study, patients were assigned in a two-group cross-over design either to low- or high-flux dialyzers (n = 9 in each group), and dialyzer membranes were changed every 4 weeks for two consecutive periods. Serum beta2-microglobulin concentrations were measured at the end of each period.
Healthy controls had a low plasma beta2-microglobulin level of 1.2 +/- 0.3 mg/l. Before hemodialysis, patients on low-flux dialyzers had a plasma beta2-microglobulin level of 42.0 +/- 14.0 mg/l, patients treated with high-flux dialyzers 21.5 +/- 10.8 mg/l (p < 0.05 vs. low-flux dialyzers). In contrast, there was no significant difference in plasma concentrations of active transforming growth factor-beta1 with the two different membrane types. The difference in serum beta2-microglobulin between low- and high-flux membranes was more prominent directly after hemodialysis as well as 4 h after hemodialysis compared with the values directly before the start of treatment. At all studied time-points, leukocytes and platelets were significantly higher in patients on low-flux membranes. Healthy control persons exhibited a significantly higher amount of beta2-microglobulin bound to granulocytes, lymphocytes, and monocytes compared with dialysis patients. Interestingly, beta2-microglobulin bound to granulocytes, lymphocytes, and monocytes was significantly increased in patients treated with high-flux membranes compared with low-flux filters. Quantitative |
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We revisited this important subject and measured beta2-microglobulin in the plasma of healthy individuals (n = 8), and patients undergoing hemodialysis (n = 20) who for assigned periods of time were either treated with a low-flux membrane (cuprophan) or high-flux (polyamide) dialyzer with an ELISA. The number of blood cells was determined by FACS. Beta2-microglobulin was also measured on the surface of granulocytes, lymphocytes, and monocytes before, directly after, and 4 h after hemodialysis. Expression of beta2-microglobulin, c-fos, tumor necrosis factor-alpha (TNF-alpha), and interleukin-1 mRNA was determined in whole blood samples with quantitative RT-PCR using an internal standard in parallel. In the second part of the study, patients were assigned in a two-group cross-over design either to low- or high-flux dialyzers (n = 9 in each group), and dialyzer membranes were changed every 4 weeks for two consecutive periods. Serum beta2-microglobulin concentrations were measured at the end of each period.
Healthy controls had a low plasma beta2-microglobulin level of 1.2 +/- 0.3 mg/l. Before hemodialysis, patients on low-flux dialyzers had a plasma beta2-microglobulin level of 42.0 +/- 14.0 mg/l, patients treated with high-flux dialyzers 21.5 +/- 10.8 mg/l (p < 0.05 vs. low-flux dialyzers). In contrast, there was no significant difference in plasma concentrations of active transforming growth factor-beta1 with the two different membrane types. The difference in serum beta2-microglobulin between low- and high-flux membranes was more prominent directly after hemodialysis as well as 4 h after hemodialysis compared with the values directly before the start of treatment. At all studied time-points, leukocytes and platelets were significantly higher in patients on low-flux membranes. Healthy control persons exhibited a significantly higher amount of beta2-microglobulin bound to granulocytes, lymphocytes, and monocytes compared with dialysis patients. Interestingly, beta2-microglobulin bound to granulocytes, lymphocytes, and monocytes was significantly increased in patients treated with high-flux membranes compared with low-flux filters. Quantitative RT-PCR revealed no significant difference in beta2-microglobulin expression in whole blood before hemodialysis, directly after hemodialysis, and 4 h after hemodialysis. However, TNF-alpha and c-fos transcripts were significantly higher in whole blood obtained from patients treated with low-flux membranes compared to high-flux dialyzers. The two-group cross-over study over three periods of 4 weeks revealed that switching from low-flux to high-flux dialyzers significantly reduced serum beta2-microglobulin levels.
Patients treated with a polyamide high-flux membrane had lower beta2-microglobulin concentrations compared with those patients on low-flux dialyzers. This difference might not be mediated by an increase in beta2-microglobulin mRNA, but may be caused by less beta2-microglobulin released from the blood cells in patients treated with high-flux dialyzers, in addition to a better beta2-microglobulin clearance.</description><identifier>ISSN: 0253-5068</identifier><identifier>EISSN: 1421-9735</identifier><identifier>PMID: 17957097</identifier><identifier>CODEN: BLPUDO</identifier><language>eng</language><publisher>Basel: Karger</publisher><subject>Adult ; Aged ; Amyloidosis - prevention & control ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; beta 2-Microglobulin - analysis ; beta 2-Microglobulin - genetics ; beta 2-Microglobulin - metabolism ; Biological and medical sciences ; Blood Cells - metabolism ; Case-Control Studies ; Cellulose - analogs & derivatives ; Cross-Over Studies ; Emergency and intensive care: renal failure. Dialysis management ; Female ; Humans ; Intensive care medicine ; Male ; Medical sciences ; Membranes, Artificial ; Middle Aged ; Nylons ; Renal Dialysis - adverse effects ; Renal Dialysis - instrumentation ; RNA, Messenger - analysis</subject><ispartof>Blood purification, 2007, Vol.25 (5-6), p.432-440</ispartof><rights>2008 INIST-CNRS</rights><rights>2007 S. Karger AG, Basel</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,777,781,4010</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=20010859$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17957097$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>TRAUT, Mario</creatorcontrib><creatorcontrib>HAUFE, Christoph C</creatorcontrib><creatorcontrib>EISMANN, Ulrike</creatorcontrib><creatorcontrib>DEPPISCH, Reinhold M</creatorcontrib><creatorcontrib>STEIN, Günter</creatorcontrib><creatorcontrib>WOLF, Gunter</creatorcontrib><title>Increased Binding of Beta-2-Microglobulin to Blood Cells in Dialysis Patients Treated with High-Flux Dialyzers Compared with Low-Flux Membranes Contributed to Reduced Beta-2-Microglobulin Concentrations: Results of a Cross-Over Study</title><title>Blood purification</title><addtitle>Blood Purif</addtitle><description>Patients on long-term dialysis eventually develop amyloid deposits with beta2-microglobulin as a predominant component. Although several studies have suggested that high-flux membranes reduce beta2-microglobulin in plasma compared with low-flux dialyzers, the mechanisms underlying this observation are still discussed.
We revisited this important subject and measured beta2-microglobulin in the plasma of healthy individuals (n = 8), and patients undergoing hemodialysis (n = 20) who for assigned periods of time were either treated with a low-flux membrane (cuprophan) or high-flux (polyamide) dialyzer with an ELISA. The number of blood cells was determined by FACS. Beta2-microglobulin was also measured on the surface of granulocytes, lymphocytes, and monocytes before, directly after, and 4 h after hemodialysis. Expression of beta2-microglobulin, c-fos, tumor necrosis factor-alpha (TNF-alpha), and interleukin-1 mRNA was determined in whole blood samples with quantitative RT-PCR using an internal standard in parallel. In the second part of the study, patients were assigned in a two-group cross-over design either to low- or high-flux dialyzers (n = 9 in each group), and dialyzer membranes were changed every 4 weeks for two consecutive periods. Serum beta2-microglobulin concentrations were measured at the end of each period.
Healthy controls had a low plasma beta2-microglobulin level of 1.2 +/- 0.3 mg/l. Before hemodialysis, patients on low-flux dialyzers had a plasma beta2-microglobulin level of 42.0 +/- 14.0 mg/l, patients treated with high-flux dialyzers 21.5 +/- 10.8 mg/l (p < 0.05 vs. low-flux dialyzers). In contrast, there was no significant difference in plasma concentrations of active transforming growth factor-beta1 with the two different membrane types. The difference in serum beta2-microglobulin between low- and high-flux membranes was more prominent directly after hemodialysis as well as 4 h after hemodialysis compared with the values directly before the start of treatment. At all studied time-points, leukocytes and platelets were significantly higher in patients on low-flux membranes. Healthy control persons exhibited a significantly higher amount of beta2-microglobulin bound to granulocytes, lymphocytes, and monocytes compared with dialysis patients. Interestingly, beta2-microglobulin bound to granulocytes, lymphocytes, and monocytes was significantly increased in patients treated with high-flux membranes compared with low-flux filters. Quantitative RT-PCR revealed no significant difference in beta2-microglobulin expression in whole blood before hemodialysis, directly after hemodialysis, and 4 h after hemodialysis. However, TNF-alpha and c-fos transcripts were significantly higher in whole blood obtained from patients treated with low-flux membranes compared to high-flux dialyzers. The two-group cross-over study over three periods of 4 weeks revealed that switching from low-flux to high-flux dialyzers significantly reduced serum beta2-microglobulin levels.
Patients treated with a polyamide high-flux membrane had lower beta2-microglobulin concentrations compared with those patients on low-flux dialyzers. This difference might not be mediated by an increase in beta2-microglobulin mRNA, but may be caused by less beta2-microglobulin released from the blood cells in patients treated with high-flux dialyzers, in addition to a better beta2-microglobulin clearance.</description><subject>Adult</subject><subject>Aged</subject><subject>Amyloidosis - prevention & control</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>beta 2-Microglobulin - analysis</subject><subject>beta 2-Microglobulin - genetics</subject><subject>beta 2-Microglobulin - metabolism</subject><subject>Biological and medical sciences</subject><subject>Blood Cells - metabolism</subject><subject>Case-Control Studies</subject><subject>Cellulose - analogs & derivatives</subject><subject>Cross-Over Studies</subject><subject>Emergency and intensive care: renal failure. Dialysis management</subject><subject>Female</subject><subject>Humans</subject><subject>Intensive care medicine</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Membranes, Artificial</subject><subject>Middle Aged</subject><subject>Nylons</subject><subject>Renal Dialysis - adverse effects</subject><subject>Renal Dialysis - instrumentation</subject><subject>RNA, Messenger - analysis</subject><issn>0253-5068</issn><issn>1421-9735</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2007</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNptkcFuEzEQhlcIREPhFZAvcLNkr9frNTeytLRSqlYl98hre1Mj7zp47LbhjXkLHCXlxGk0o0___8_Mq2pBm5piKRh_XS1IzRnmpO3OqncAPwmhTcvl2-qMCskFkWJR_bmedbQKrEFLNxs3b1EY0dImhWt843QMWx-G7N2MUkBLH4JBvfUeUJl8c8rvwQG6U8nZOQFaF61UtJ5cekBXbvuAL31-PoK_bQTUh2mn4guxCk9H4MZOQ1SzPQBzim7IB5XieG9N1odw_0tUWF1sY3EPM3wpMGRfUpQNFOpjAMC3jzaiHymb_fvqzag82A-nel6tLy_W_RVe3X6_7r-u8K5rBGYj40Z1kpm2li2VllHRcGvJaMaa6NJ2nbKDIIIqXTekpQNlxLBRjrKuecfOq89H2V0Mv7KFtJkc6HKxsl3IsBGEtEWRFPDjCczDZM1mF92k4n7z8psCfDoBCrTyY7mPdvCPq8s7Sccl-wuC0Jxk</recordid><startdate>2007</startdate><enddate>2007</enddate><creator>TRAUT, Mario</creator><creator>HAUFE, Christoph C</creator><creator>EISMANN, Ulrike</creator><creator>DEPPISCH, Reinhold M</creator><creator>STEIN, Günter</creator><creator>WOLF, Gunter</creator><general>Karger</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7X8</scope></search><sort><creationdate>2007</creationdate><title>Increased Binding of Beta-2-Microglobulin to Blood Cells in Dialysis Patients Treated with High-Flux Dialyzers Compared with Low-Flux Membranes Contributed to Reduced Beta-2-Microglobulin Concentrations: Results of a Cross-Over Study</title><author>TRAUT, Mario ; HAUFE, Christoph C ; EISMANN, Ulrike ; DEPPISCH, Reinhold M ; STEIN, Günter ; WOLF, Gunter</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-p847-3f35da893d629619e31745ee0fdf20ce3188aeb7071ac24061b130d3f9f922583</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2007</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Amyloidosis - prevention & control</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>beta 2-Microglobulin - analysis</topic><topic>beta 2-Microglobulin - genetics</topic><topic>beta 2-Microglobulin - metabolism</topic><topic>Biological and medical sciences</topic><topic>Blood Cells - metabolism</topic><topic>Case-Control Studies</topic><topic>Cellulose - analogs & derivatives</topic><topic>Cross-Over Studies</topic><topic>Emergency and intensive care: renal failure. Dialysis management</topic><topic>Female</topic><topic>Humans</topic><topic>Intensive care medicine</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Membranes, Artificial</topic><topic>Middle Aged</topic><topic>Nylons</topic><topic>Renal Dialysis - adverse effects</topic><topic>Renal Dialysis - instrumentation</topic><topic>RNA, Messenger - analysis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>TRAUT, Mario</creatorcontrib><creatorcontrib>HAUFE, Christoph C</creatorcontrib><creatorcontrib>EISMANN, Ulrike</creatorcontrib><creatorcontrib>DEPPISCH, Reinhold M</creatorcontrib><creatorcontrib>STEIN, Günter</creatorcontrib><creatorcontrib>WOLF, Gunter</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>MEDLINE - Academic</collection><jtitle>Blood purification</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>TRAUT, Mario</au><au>HAUFE, Christoph C</au><au>EISMANN, Ulrike</au><au>DEPPISCH, Reinhold M</au><au>STEIN, Günter</au><au>WOLF, Gunter</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Increased Binding of Beta-2-Microglobulin to Blood Cells in Dialysis Patients Treated with High-Flux Dialyzers Compared with Low-Flux Membranes Contributed to Reduced Beta-2-Microglobulin Concentrations: Results of a Cross-Over Study</atitle><jtitle>Blood purification</jtitle><addtitle>Blood Purif</addtitle><date>2007</date><risdate>2007</risdate><volume>25</volume><issue>5-6</issue><spage>432</spage><epage>440</epage><pages>432-440</pages><issn>0253-5068</issn><eissn>1421-9735</eissn><coden>BLPUDO</coden><abstract>Patients on long-term dialysis eventually develop amyloid deposits with beta2-microglobulin as a predominant component. Although several studies have suggested that high-flux membranes reduce beta2-microglobulin in plasma compared with low-flux dialyzers, the mechanisms underlying this observation are still discussed.
We revisited this important subject and measured beta2-microglobulin in the plasma of healthy individuals (n = 8), and patients undergoing hemodialysis (n = 20) who for assigned periods of time were either treated with a low-flux membrane (cuprophan) or high-flux (polyamide) dialyzer with an ELISA. The number of blood cells was determined by FACS. Beta2-microglobulin was also measured on the surface of granulocytes, lymphocytes, and monocytes before, directly after, and 4 h after hemodialysis. Expression of beta2-microglobulin, c-fos, tumor necrosis factor-alpha (TNF-alpha), and interleukin-1 mRNA was determined in whole blood samples with quantitative RT-PCR using an internal standard in parallel. In the second part of the study, patients were assigned in a two-group cross-over design either to low- or high-flux dialyzers (n = 9 in each group), and dialyzer membranes were changed every 4 weeks for two consecutive periods. Serum beta2-microglobulin concentrations were measured at the end of each period.
Healthy controls had a low plasma beta2-microglobulin level of 1.2 +/- 0.3 mg/l. Before hemodialysis, patients on low-flux dialyzers had a plasma beta2-microglobulin level of 42.0 +/- 14.0 mg/l, patients treated with high-flux dialyzers 21.5 +/- 10.8 mg/l (p < 0.05 vs. low-flux dialyzers). In contrast, there was no significant difference in plasma concentrations of active transforming growth factor-beta1 with the two different membrane types. The difference in serum beta2-microglobulin between low- and high-flux membranes was more prominent directly after hemodialysis as well as 4 h after hemodialysis compared with the values directly before the start of treatment. At all studied time-points, leukocytes and platelets were significantly higher in patients on low-flux membranes. Healthy control persons exhibited a significantly higher amount of beta2-microglobulin bound to granulocytes, lymphocytes, and monocytes compared with dialysis patients. Interestingly, beta2-microglobulin bound to granulocytes, lymphocytes, and monocytes was significantly increased in patients treated with high-flux membranes compared with low-flux filters. Quantitative RT-PCR revealed no significant difference in beta2-microglobulin expression in whole blood before hemodialysis, directly after hemodialysis, and 4 h after hemodialysis. However, TNF-alpha and c-fos transcripts were significantly higher in whole blood obtained from patients treated with low-flux membranes compared to high-flux dialyzers. The two-group cross-over study over three periods of 4 weeks revealed that switching from low-flux to high-flux dialyzers significantly reduced serum beta2-microglobulin levels.
Patients treated with a polyamide high-flux membrane had lower beta2-microglobulin concentrations compared with those patients on low-flux dialyzers. This difference might not be mediated by an increase in beta2-microglobulin mRNA, but may be caused by less beta2-microglobulin released from the blood cells in patients treated with high-flux dialyzers, in addition to a better beta2-microglobulin clearance.</abstract><cop>Basel</cop><pub>Karger</pub><pmid>17957097</pmid><tpages>9</tpages></addata></record> |
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| ispartof | Blood purification, 2007, Vol.25 (5-6), p.432-440 |
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| source | MEDLINE; Karger Journals |
| subjects | Adult Aged Amyloidosis - prevention & control Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy beta 2-Microglobulin - analysis beta 2-Microglobulin - genetics beta 2-Microglobulin - metabolism Biological and medical sciences Blood Cells - metabolism Case-Control Studies Cellulose - analogs & derivatives Cross-Over Studies Emergency and intensive care: renal failure. Dialysis management Female Humans Intensive care medicine Male Medical sciences Membranes, Artificial Middle Aged Nylons Renal Dialysis - adverse effects Renal Dialysis - instrumentation RNA, Messenger - analysis |
| title | Increased Binding of Beta-2-Microglobulin to Blood Cells in Dialysis Patients Treated with High-Flux Dialyzers Compared with Low-Flux Membranes Contributed to Reduced Beta-2-Microglobulin Concentrations: Results of a Cross-Over Study |
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