Heidenreich S, Schmidt M, Harrach B, Rahn KH
Monocyte apoptosis in chronic hemodialysis patients
33rd Congress of the Eur Dial Transplant Assoc
Nephrol Dial Transplant
(Jun) 11:A129 1996
The risk of infection is high in dialysis patients (HD). Monocytes
play a key role in immune defense. This study tests the hypothesis
that enhanced monocyte apoptosis is an additional alteration of the
immune system in uremic patients.
Monocyte DNA fragmentation was higher in HD subjects than in
healthy controls both in the short term (24h: 48% Vs 23%, p <0.01) and
long term (up to 120 hrs) cell cultures. Apoptosis in monocytes of HD
patients was confirmed by electron microscopy and DNA electrophoresis
of cleaved chromatin and was paralleled by an impaired microbicidal
capacity. Monocytes obtained after hemodialysis had normal DNA
fragmentation levels with no difference between cuprophane and
polysulfone membranes. Addition of exogenous TNF-alfa to pre-HD
monocyte cultures normalized DNA fragmentation, suggesting that
cytokines regulate monocyte senescence. Uremic patients on
conservative treatment also showed increased apoptosis whereas no
such alteration was found in CAPD patients.
Comment: Enhanced monocyte apoptosis in end-stage renal
failure may have a role in the impaired cellular host defense in
these patients (Carlo Basile, M.D., Taranta, Italy).
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33rd Congress of the Eur Dial Transplant Assoc
CRF by problem area :
Infections (other than hepatitis, peritonitis)