MONOCYTE PRODUCTION OF TRANSFORMING GROWTH-FACTOR-BETA IN LONG-TERM HEMODIALYSIS - MODULATION BY HEMODIALYSIS MEMBRANES

Cytokines are likely involved in hemodialysis-associated complications such as immunodeficiency and beta(2) microglobulin amyloidosis, Becau se transforming growth factors beta (TGF beta) exert immunosuppressive effects on lymphocytes, down-modulate monocyte functions, and promote fibrosis, we hypothesize that they participate in the deleterious eff ects of hemodialysis, We investigated the production of TGF beta(1) an d TGF beta(2) by monocytes from controls and patients dialyzed with hi gh-flux cellulose triacetate (CT) and polyacrylonitrile (PAN) membrane s, The detection of both TGF beta s required an acidification step, su ggesting that they are secreted as latent complexes, The spontaneous p roduction of TGF beta(1) and TGF beta(2) was significantly higher in p atients dialyzed with CT or PAN than in controls, but the oversecretio n of TGF beta(1) was more sustained in CT-treated patients than in PAN -dialyzed patients, The production of interleukin-6 (IL-6) was increas ed in both patient groups as compared with controls, In contrast to TG F beta(1), the increase was greater in PAN-treated patients than in CT -treated patients, and the release of tumor necrosis factor alpha (TNF alpha) was increased only in PAN-treated patients. Taken together, ou r results show that hemodialysis is associated with the oversecretion of monocyte cytokines. Moreover, the type of dialysis membrane specifi cally affects the balance between the secretion of suppressive cytokin es such as TGF beta and that of inflammatory cytokines such as IL-6 an d TNF alpha. (C) 1996 by the National Kidney Foundation, Inc.