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Title: Online haemodiafiltration improves inflammatory state in dialysis patients: A longitudinal study
Author: Rama, Inés
Llaudó Vallmajor, Inés
Fontova, Pere
Cerezo, Gema
Soto, Carlos
Javierre Garcés, Casimiro F.
Hueso Val, Miguel
Montero, Nuria
Martínez Castelao, Alberto
Torras Ambròs, Joan
Grinyo Boira, Josep M.
Cruzado, Josep Ma.
Lloberas Blanch, Núria
Keywords: Diàlisi
Cèl·lules dendrítiques
Malalties hematològiques
Dendritic cells
Hematologic diseases
Issue Date: 26-Oct-2016
Publisher: Public Library of Science (PLoS)
Abstract: Background: Patients undergoing conventiona l hemodialysis (C-HD) present a greater immuno-inflam- matory state probably related to uremia, sympathetic nervous system (SNS) activation and /or membrane bioincompat ibility, which could improve with a technique-switch ing to online hemodiafiltration (OL-HD). The antigen-indep endent pathway activation of this modified immunologic state turns dendritic cells (DC) into an accurate cell model to study these patients. The aim of this study is to further evaluate the immune-inflammat ory state of patients in C-HD assessed by DC maturation. Methods: 31 patients were submitted to C-HD and after 4 months switched to the OL-HD technique. Monocytes-derive d DCs from HD patients were cultured in the presence of IL-4/GM-CSF. DC-maturation was evaluated by assessing the maturation phenotype by flow cytometry (FACs). DCs-functiona l capacity to elicit T-cell alloresponse was studied by mixed leuco- cyte reaction. Cytokine release was assessed by FACs and SNS was evaluated measuring renalase levels by ELISA. Results: An up-regulation of maturation markers was observed in C-HD DCs which induced two fold more T cells proliferation than OL-HD DCs. Also, C-HD-mDCs presented with over-produc- tion of pro-inflammatory cytokines (IL-6, IL-1 β , IL-8, IL-10 and TNF- α ) compared with OL- HD-mDC (P < 0·05). Results were correlated with clinical data. When SNS was evaluated, hypotension events and blood pressure were significantly lower and renalase levels were significantly higher after conversion to OL-HD. Diabetes mellitus type 2 patients also found beneficial reduction of mDC when converted to OL-HD compared to non-diabetics. Conclusions: OL-HD could interfere with immuno-inflammatory state in HD patients with an improvement of renalase levels as potential key mediators in the mechanistic pathway of down-regulation of DC maturation
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It is part of: PLoS One, 2016, vol. 11, num. 10, p. e0164969
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ISSN: 1932-6203
Appears in Collections:Articles publicats en revistes (Ciències Clíniques)
Articles publicats en revistes (Ciències Fisiològiques)
Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))

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