The Effect Of Dialysis Membrane On PBMC Activation And Oxidative Stress System In Hemodialysis Patients

Objective:To investigate the plasma level of interleukin-13 (IL-13),interleukin-18 (IL-18) and the effect of different dialysis membrane on peripheral blood mononuclear cells (PBMC) synthesis and release level of IL-13,IL-18 and the oxidative stress in patients with maintanence hemodialysis (MHD). To evaluate that if IL-I3,IL-18 can be biocompatibility indexes of dialyzer.Methods:The levels of IL-I3 and IL-18 in plasma and supernatants of PBMC cultured with or without stimulation were measured by enzyme linked immunosorbent assay (ELISA) method in all groups . The expression of IL-13 and IL-18 mRNA in PBMC were evaluated by reverse transcriptase polymerase chain reaction (RT-PCR). Patients in MHD groups were dialyzed with regenerated cellulose membrane (650 group) and polysulform membrane (F6 group) respectively. At the same time, thirty patients on MHD were divided into three groups randomly. The Patients were dialyzed with regenerated cellulose membrane (650 group),polysulform membrane (F6 group) and Vitamin E-modified membrane (CL-E group)respectively. Blood samples were collected before and after dialysis to determine the concentrations of malonylaldehyde (MDA),vitamin E (Vit E),total anti-oxidation capacity (T-AOC),advanced oxidation protein products (AOPP) in plasma. Ten healthy persons and ten end stage renal disease (ESRD) patients with non-hemodialysis were as controls(CON groups).Results:The plasma levels of IL-13,IL-18 in ESRD with non-hemodialysis group and MHD group before hemodialysis were higher significantly than those of healthy controls(P<0.05). After dialysis, the plasma levels of IL-18 were not obviously changed (P>0.05) and the plasma levels of IL-13 were decreased (P<0.05) in MHD groups. The plasma lever of IL-13, IL-18 and dialysis age , KT/V have no correlation (P>0.05). After PBMC were stimulated, the level of IL-13,IL-18 significantly decreased in ESRD with non-hemodialysis group (P<0.05); in 650 group, the level of IL-13 have no obviously changes (P>0.05) and the level of IL-18 decreased(P<0.05); the level of IL-13,IL-18 in F6 group significantly increased (P<0.05), but the increased levels were lower than that in healthy controls.The plasma levels of MDA and AOPP in ESRD patients with no-dialysis were higher significantly than those of healthy controls (P<0.05). The plasma levels of T-AOC and VitE in ESRD patients with no-dialysis have no obviously changes than that in controls. The plasma levels of AOPP were no marked changes after dialysis in MHD groups (P<0.05), but obvious decline in T-AOC levels (P<0.01).There was no obviously changes in the levels of MDA in 650 group and F6 group after dialysis. The level of MDA was marked declined (P<0.05) and the level of VitE was increased (P>0.05) in CL-E group after dialysis.Conclusion:1,The plasma levels of IL-13,IL-18 in ESRD is higher than those of healthy controls. These suggest that the microinflammatory state is present in ESRD patients.2,HD can not decrease the level of IL-18, but can decrease the level of IL-13. MHD can not improve the microinflammatory state, further damage the anti-inflammatory ability, and have no significant difference between cellulose and polysulform membrane.3,The polysulform membranes can improve the immune function of PBMC. IL-13 and IL-18 can be biocompatibility indexes of dialyzer.4,The oxidative stress is present in ESRD patients. VitE - modified membrane can improve the oxidative stress in MHD.