TY - JOUR
T1 - Vitamin E-loaded dialyzer resets PBMC-operated cytokine network in dialysis patients
AU - Libetta, Carmelo
AU - Zucchi, Manuela
AU - Gori, Elena
AU - Sepe, Vincenzo
AU - Galli, Francesco
AU - Meloni, Federica
AU - Milanesi, Fabio
AU - Dal Canton, Antonio
PY - 2004/4
Y1 - 2004/4
N2 - Background. In hemodialysis patients the activity of stimulated Th1 lymphocytes is depressed, while Th2 cells are constitutively primed. Such phenomena may depend on monocyte activation and altered release of interleukin (IL)-12 and IL-18, which regulate Th cell differentiation. Reactive oxygen species (ROS) activate monocytes; therefore, a hemodialyzer with antioxidant activity would contrast ROS, prevent monocyte activation, reset IL-12 and IL-18 release, and restore Th1/Th2 balance. Methods. Ten patients on regular dialysis treatment (RDT) with cellulosic membrane (CM) were shifted to vitamin E-coated dialyzer (VE). During treatment with CM and after 3, 6, and 12 months of treatment with VE, peripheral blood mononuclear cells (PBMC) and purified CD4+ cells were isolated, and cultured, resting, mitogen-stimulated, and interferon γ (IFNγ), IL-4, IL-10, IL-12, and IL-18 release was measured. Vitamin E and A plasma levels and the effects of a single dialysis session on peripheral blood NO levels were assayed. Results. The constitutive release of IL-4 and IL-10 by CD4+ cells was abated significantly by treatment with VE (nadir -77.8% and -55.3%, respectively, at 12 months). INFγ release by mitogen-stimulated CD4+ recovered with VE (zenith +501% at 12 months). PBMC constitutive production of IL-12 and IL-18 was significantly reduced by VE (nadir at 12 months -64.7% and -51.3%, respectively). VE increased plasma levels of vitamins E and A. NO plasma levels fell after a single dialysis treatment with VE (-17%, P <0.05) in contrast with CU (+27.1%, P <0.05). Conclusion. The network of cytokines released by monocytes and Th cells is reset toward normality by treatment with vitamin E-coated dialyzer.
AB - Background. In hemodialysis patients the activity of stimulated Th1 lymphocytes is depressed, while Th2 cells are constitutively primed. Such phenomena may depend on monocyte activation and altered release of interleukin (IL)-12 and IL-18, which regulate Th cell differentiation. Reactive oxygen species (ROS) activate monocytes; therefore, a hemodialyzer with antioxidant activity would contrast ROS, prevent monocyte activation, reset IL-12 and IL-18 release, and restore Th1/Th2 balance. Methods. Ten patients on regular dialysis treatment (RDT) with cellulosic membrane (CM) were shifted to vitamin E-coated dialyzer (VE). During treatment with CM and after 3, 6, and 12 months of treatment with VE, peripheral blood mononuclear cells (PBMC) and purified CD4+ cells were isolated, and cultured, resting, mitogen-stimulated, and interferon γ (IFNγ), IL-4, IL-10, IL-12, and IL-18 release was measured. Vitamin E and A plasma levels and the effects of a single dialysis session on peripheral blood NO levels were assayed. Results. The constitutive release of IL-4 and IL-10 by CD4+ cells was abated significantly by treatment with VE (nadir -77.8% and -55.3%, respectively, at 12 months). INFγ release by mitogen-stimulated CD4+ recovered with VE (zenith +501% at 12 months). PBMC constitutive production of IL-12 and IL-18 was significantly reduced by VE (nadir at 12 months -64.7% and -51.3%, respectively). VE increased plasma levels of vitamins E and A. NO plasma levels fell after a single dialysis treatment with VE (-17%, P <0.05) in contrast with CU (+27.1%, P <0.05). Conclusion. The network of cytokines released by monocytes and Th cells is reset toward normality by treatment with vitamin E-coated dialyzer.
KW - Biocompatibility
KW - Cytokines
KW - Hemodialysis
KW - Nitric oxide
KW - Th lymphocytes
KW - Vitamin E
UR - http://www.scopus.com/inward/record.url?scp=1642504334&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=1642504334&partnerID=8YFLogxK
U2 - 10.1111/j.1523-1755.2004.00528.x
DO - 10.1111/j.1523-1755.2004.00528.x
M3 - Article
C2 - 15086491
AN - SCOPUS:1642504334
VL - 65
SP - 1473
EP - 1481
JO - Kidney International
JF - Kidney International
SN - 0085-2538
IS - 4
ER -