Stimulated IFN gamma and IL-10 secretion of blood mononuclear cells in patients on renal replacement therapies show different secretion patterns

Infection is still a leading cause of morbidity and mortality in patients o n renal replacement therapy (RRT). Although the role of the immune system i s of great importance, little is known about the influence of the mode of R RT to the preferential excretions of regulator cytokines of mononuclear cel ls. Therefore, we investigated the stimulated IFN gamma (Th1) and IL-10 (Th 2) secretions of mononuclear cells from patients on RRT. Blood was drawn fr om 10 controls, 15 patients on hemodialysis (HD), 15 on peritoneal dialysis (PD), and 10 after kidney transplantation (Tx). The cells were separated, and phytohemagglutinine (PHA) was added for stimulation. After 0, 6, and 24 h, IFN gamma and IL-10 (pg/ml) were measured by enzyme-linked immunosorben t assay. IFN gamma secretion was significantly enhanced 6 (p < 0.001) and 2 4 h (p = 0.002) after stimulation in all groups (in mean <plus/minus> SEM). The analysis of the subgroups 6 h after adding PHA showed significant diff erences (P = 0.0239) with the lowest IFN gamma in Tx (16 +/- 5) and the hig hest in PD (79 +/- 30). For IL-10, secretion was enhanced in all groups 6 h after stimulation (p < 0.0116). The lowest secretions were seen in HD (18 <plus/minus> 8) and controls (27 +/- 9); the highest secretions were in Tx (98 +/- 20) and PD (57 +/- 12). The differences between HD and Tx (p < 0.01 ) and HD versus PD (p = 0.05) were significant. The stimulated cytokine sec retion of blood mononuclear cells is preserved with RRT. The modes of RRT c ould influence the pattern of cytokine secretion. Surprisingly, the cells f rom patients on PD showed enhanced IL-10 secretion compared to HD. Presumab ly, this is due to the chronic contact of peritoneal dialysis fluids with m onocytes and the lymphatic system in PD.