CYTOKINE PRODUCTION AND CYTOTOXICITY OF LYMPHOCYTES IN PATIENTS ON MAINTENANCE SHORT-TERM OR LONG-TERM HEMODIALYSIS

The lymphocyte-mediated cytotoxicity and cytokine production of patien ts under maintenance haemodialysis were studied. The patients were sub divided into two groups; 27 patients receiving haemodialysis treatment for up to 3 years (group 1) and 27 patients for longer than 10 years (group 2). Twenty-six healthy volunteers (group 3) were used as contro ls. The immunological parameters assayed were NK cell and lymphokine-a ctivated killer (LAK) cell activities, and production of both interfer on (IFN)-gamma and tumour necrosis factor (TNF)-alpha by either periph eral blood mononuclear cells (PBMC) cultured with IL-2 or LAK cells. I n group 1 both NK- and LAK-cell-mediated cytotoxicities were significa ntly suppressed as compared to those in group 3. The titre of IFN prod uced by LAK cells was also less than that in group 3. On the contrary there were no significant differences in cytokine production by PBMC i n all three groups. Percentage of the cases with suppressed cytokine p roduction seemed higher in group 1 than group 3. In addition there was a close correlation between the value of IFN-gamma and of TNF-alpha p roduced by PBMC in the patients on haemodialysis. Both the type of dia lysis membranes used and the primary diseases did not significantly in fluence the results in group 1 and group 2. From these results it coul d be speculated that there are more patients with impaired immune func tion in group 1 than in group 3. In contrast there was no significant difference in the immune function tested between group 2 and group 3. Our results indicate the need for a study on time kinetics concerning the change in suppressed immune function of the patients and their cli nical courses shortly after the beginning of haemodialysis.