CYTOKINE PRODUCTION BY PERIPHERAL-BLOOD MONONUCLEAR-CELLS FROM PEDIATRIC CHRONIC PERITONEAL-DIALYSIS PATIENTS

Previous reports have documented impaired cytokine production by perit oneal macrophages in chronic peritoneal dialysis (CPD) patients. To de termine if this observed defect was a reflection of systemic mononucle ar cell dysfunction, the function of peripheral blood mononuclear cell s obtained from pediatric patients on CPD was assessed after stimulati on with lipopolysaccharide (LPS). Levels of interleukin-1 beta (IL-1 b eta) and tumor necrosis factor-alpha (TNF-alpha) mRNA and protein were measured before and after stimulation with LPS. There was no signific ant difference in the response of mononuclear cells from CPD patients and normal controls in terms of increase in TNF-alpha mRNA [median sti mulation index (SI) = 6.6 vs. 3.7, P = 0.35] or IL-1 beta mRNA (median SI = 6.2 vs. 6.5, P = 1.0). There was also no significant difference between the median increase in TNF-alpha protein secretion (median 372 pg/ml vs. 373 pg/ml, P = 0.60). These results suggest that systemic m ononuclear cell function may be intact in CPD patients, and therefore this does not account for the dysfunction of peritoneal macrophages th at has been previously reported.