IN-VIVO INDUCTION OF MONOCYTE CHEMOTACTIC AND ACTIVATING FACTOR IN PATIENTS WITH CHRONIC-RENAL-FAILURE

Background. Monocyte chemotactic and activating factor (MCAF) is a nov el inflammatory cytokine belonging to the chemokine superfamily and st imulates chemotaxis and activation of monocytes. Increased production of inflammatory cytokines has been shown in patients with end-stage re nal disease (ESRD). This study was thus conducted to determine plasma MCAF in patients with ESRD. Methods. Plasma levels of MCAF were determ ined by ELISA. Gene expression of MCAF in PBMC was assessed by RT-PCR followed by southern blot hybridization. Results. Plasma MCAF in 72 pa tients with long-term haemodialysis (HD) (162.4 +/- 58.2 pg/ml) and ei ght uraemic patients not yet dialysed (167.6 +/- 57.7 pg/ml) was found to exceed significantly the level in 24 normal subjects (86.0 +/- 19. 4 pg/ml). MCAF before HD session in long-term HD patients was the same whether HD was carried out with either cellulosic (CUP) or synthetic (PMMA) membrane dialysers. Intradialytic increase in plasma MCAF durin g a single HD session was observed in both patient groups dialysed wit h CUP or PMMA membranes. The results of RT-PCR analysis indicated that haemodialysis stimulates the gene expression of MCAF in PBMC in vivo. Conclusions. The present results indicate that increased levels of pl asma MCAF may promote the activation of monocytes in patients with ESR D.