P. Thylen et al., CELL-SURFACE RECEPTOR MODULATION ON MONOCYTES AND GRANULOCYTES DURINGCLINICAL AND EXPERIMENTAL HEMODIALYSIS, American journal of nephrology, 15(5), 1995, pp. 392-400
We studied the modulation of cell surface receptors related to cell ad
hesion (L-selectin and Mac-1) on monocytes and granulocytes during cli
nical (7 patients treated with cuprophan, Cu, and polysulfone, PS, mem
branes, n = 14) and experimental Cu and PS hemodialysis (n = 14). The
objective was to compare cell surface receptor modulation in vivo when
large subpopulations of cells are withdrawn from the circulating pool
with the experimental model when cells are not sequestrated. The expr
ession of Mac-1 and L-selectin on monocytes increased during clinical
Cu dialysis (p = 0.024 and p = 0.0096, respectively) but remained stab
le during PS dialysis. On granulocytes, an inverse receptor modulation
of Mac-1 and L-selectin was observed during clinical Cu dialysis but
not during PS dialysis. Mac-1 was significantly higher and L-selectin
lower on granulocytes after 15 min of clinical Cu as compared to PS di
alysis (p = 0.001 and p = 0.0093, respectively). During experimental C
u dialysis, Mac-1 expression increased and L-selectin decreased marked
ly and continuously on both monocytes and granulocytes. The L selectin
/Mac-1 ratio on monocytes and granulocytes may be used as an index of
the ability of leukocytes to adhere and to be recruited to an inflamma
tory focus. This ratio was significantly lower during clinical Cu as c
ompared to PS dialysis (p = 0.0008 and p = 0.0015, respectively) indic
ating that the recruitment of leukocytes to infection foci may be prec
luded in patients on Cu membranes. Both monocytes and granulocytes sho
wed significantly Lower L-selectin/Mac-1 ratio during and after experi
mental Cu as compared to PS dialysis. Altered adhesion molecule phenot
ype on inflammatory cells during hemodialysis may influence the suscep
tibility to infections. Increased shedding of L-selectin in parallel w
ith upregulation of Mac-1 may play an important role. Experimental hem
odialysis provides information on the mechanisms involved in this proc
ess.