C. Sirtl et al., THE INFLUENCE OF COLLOIDAL PLASMA SUBSTIT UTES ON THE RELEASE OF TUMOR-NECROSIS-FACTOR-ALPHA (TNF-ALPHA) IN HUMAN WHOLE-BLOOD IN-VITRO, Infusionstherapie und Transfusionsmedizin, 22(6), 1995, pp. 332-338
Objective: To investigate the influence of colloidal plasma substitute
s on human cytokine network, especially of tumor necrosis factor alpha
(TNF-alpha), in vitro. Design: Heparinized whole blood samples from 8
healthy volunteers were divided and set on various concentrations of
artificial colloidal plasma substitutes (native = 0 mg/ml; 5 mg/ml; 15
mg/ml). As colloids were used hydroxyethyl starch 200/0,5 (HES), dext
ran 60 (DX), urea-linked gelatin (GEL) and human albumin solution (HA)
. After incubation (24 h; 5% CO2; 37 degrees C; with and without conco
mitant stimulation of blood cells with phytohemagglutinin [PHA]) measu
rement of TNF-alpha release was performed via ELISA by the method desc
ribed by Gallati. For the statistical evaluation a repeated measures a
nalysis of variance was used. Results: Basic level of TNF-alpha was fo
und between 226 and 273 pg/ml (0 mg of each colloid/ml), stimulation w
ith PHA without any colloid increased the TNF-alpha level about fourfo
ld (1,066-1,260 pg/ml; 0 mg of each colloid/ml). At 5 mg/ml and 15 mg/
ml without PHA all 3 artificial colloids rose the level of TNF-alpha (
up to 50%). Under concomitant stimulation each colloid induced additio
nal TNF-alpha release in comparison to PHA alone. The changes elicited
by DX and GEL were statistically significant (p<0.001 and p=0.005, re
spectively) in contrast to those induced by human albumin solution or
HES. Conclusion: In relation to TNF-alpha plasma substitutes are not i
nert substances as perhaps suspected. The questions whether the observ
ed effects exist in vivo, how far other cytokines are influenced and t
he question about the clinical importance are subject of ongoing studi
es.