EFFECT OF IMMUNOGLOBULIN LIGHT-CHAINS FROM HEMODIALYSIS AND CONTINUOUS AMBULATORY PERITONEAL-DIALYSIS PATIENTS ON POLYMORPHONUCLEAR LEUKOCYTE FUNCTIONS

Circulating plasma factors accumulating in the serum of uremic patient s have the potential to inhibit essential functions of polymorphonucle ar leukocytes (PMNL). As a consequence, these factors can contribute t o the increased risk for bacterial infections generally found in uremi c patients. Free immunoglobulin light chains that are present in the s erum of healthy adults at low levels appear in the serum of uremic pat ients at significantly higher levels, Therefore, kappa and lambda ligh t chains in their monomeric and dimeric forms were isolated from hemod ialysis and continuous ambulatory peritoneal dialysis patients and the ir potential to inhibit essential PMNL functions in in vitro assays wa s tested, It was found that all isolates tested were able to inhibit d eoxyglucose uptake, a measure for the state of activation of PMNL, as well as chemotaxis. In contrast, free immunoglobulin light chains had no influence on the phagocytotic functions of PMNL, It was concluded t hat free immunoglobulin light chains are able to act as uremic toxins by interfering with essential PMNL functions and that their serum leve ls and fate during the treatment of uremic patients should be taken in to consideration.