EFFECT OF HEMODIALYSIS ON PERIPHERAL-BLOOD MONOCYTE TUMOR-NECROSIS-FACTOR-ALPHA, INTERLEUKIN-6, AND INTERLEUKIN-8 SECRETION IN-VITRO

The influence of blood-membrane interaction on human peripheral blood monocyte tumor necrosis factor-alpha (TNF), interleukin-6 (IL-6), and interleukin-8 (IL-8) secretion was measured during hemodialysis of end -stage renal disease patients by in vitro stimulation of whole blood w ith lipopolysaccharide. Monocyte TNF and IL-6 secretion in vitro was r educed 30 min after start of dialysis session. In contrast, cellular I L-8 secretion did not change during hemodialysis. Comparison of the re sults of three different membranes indicates that the bioincompatibili ty of the dialysis membrane was reflected in both leukocytopenia and r eduction of cellular TNF secretion. During treatment of normal whole b lood in an ex vivo dialysis closed-loop circuit, the ability of monocy tes to release TNF, IL-6, and IL-8 in vitro remained constant. This in dicates that the reduced IL-6 and TNF secretion during standard hemodi alysis was not due to a direct effect of contact between dialysis memb ranes and monocytes, but rather was a result of redistribution within the patients' leukocyte pool.