Krautzig S, Lonneman G, Koch KM
Penetration of exotoxin-A related cytokine-inducing substances
through dialyzer membranes
International Society of Blood Purification
Blood Purif
(Sep) 13:(supp.1)61 1995
Gram negative bacteria grow in dialysate and release cytokine inducing
substances including
lipopolysaccharides (LPS), peptidoglycans, muramyl peptides, exotoxins and
the fragments of
exotoxins and LPS. Intact LPS and a component of it called Lipid A (a 4kd
subunit) give a
positive LAL test. Human peripheral blood mononuclear cells (PBMC) produce
cytokines when
stimulated by any of the substances above. Intact dialyzer membranes may be
permeable to
some of these cytokine producing substances. Some membranes may actually
adsorb these
substances.
These investigators have raised a goat antibody to a Pseudomonas
aeruginosa
exotoxin A. Bicarbonate dialysate was contaminated with a culture filtrate
of these bacteria.
Interleukin-1B was measured by RIA in lysate of PBMC exposed to this
dialysate across a dialyzer membrane. The contaminated dialysate induced IL-
1B; this was slightly reduced by polymyxin B and further reduced by polymyxin
plus antibody
to exotoxin A. An IL-1B inducing substance permeated the polyamide membrane
and it was not
inhibited by polymyxin, but was inhibited by anti-exotoxin A antibody. Thus,
exotoxin A or
its fragments penetrate dialyzer membranes and induce IL-1B.
(T.A. Golper)
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International Society of Blood Purification
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