You are here

Home » Content

KRONÎK BÖBREK YETMEZLIKLI HASTALARDA DÎYALÎZ TEDAVÎSÎ VE REKOMBÎNANT HUMAN ERÎTROPOÎETÎNÎN LÖKOSÎT KEMOTAKSÎSÎ VE SPONTAN MIGRASYONU ÜZERİNE ETKİSİ

THE EFFECT OF DIALYSIS THERAPY AND RECOMBINANT HUMAN ERYTHROPOITEIN ON LEUKOCYTE CHEMOTAXIS AND SPONTANEOUS MIGRATION IN PATIENTS WITH CHRONIC RENAL FAILURE

Journal Name:

  • Türk Nefroloji, Diyaliz ve Transplantasyon Dergisi

Publication Year:

  • 1997

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
It is known that neutrophil chemotaxis and pha¬gocytosis which are very important in primary host defense are damaged in chronic renal failure (CRF) patients. It has been shown that recombinant human erythropoietin (rEPO) corrects leukocyte phagocyto¬sis. But, there is not enough data in the literature abo¬ut the effect of rEPO on neutrophil chemotaxis and spontaneous migration. For the reason, we have de¬signed this study to assess the effect of rEPO on neut-rophilfunctions in dialysis patients. Ten hemodialysis (HD, group 1), twelve continuo¬us ambulatory peritoneal dialysis (CAPD, group 2) and seven predialytic (group 3), totaly 29 CRF pati¬ents enrolled in this study. In addition, ten healthy vo¬lunteers (group 4) were studied as a control group. Boyden-chamber method was used to assess neutrop-hil chemotaxis and spontaneous migration. Six HD, three CAPD, totally nine patients (group 5) who had hemoglobin < 8.5 g/dl were given rEPO 100 U/kg, three times a week, subcutaneously for 30 days. Neut-rophil chemotaxis and spontaneous migration were in¬vestigated again on days 1, 7 and 30 in 5th group. Chemotactic activity was lower in group 2 compared to group 3 (p= 0.03), and was also lower in groups 1 and 2 than in group 4 (p=0.0009, p=0.0002). Sponta¬neous migration was found lower in groups 1 and 2 than in group 4 (p=0.04, p=0.01). Chemotactic capa¬city was increased significantly on day 7 according to day 1 (p=0.01) and also day 30 compared to days 0 and 1 in group 5 (p= 0.02, p =0.03). Spontaneous migration was higher on day 30 than days 0 and 1 in the last group (p=0.02, p=0.02) In conclusion, these findings suggested that neut-rophilfunctions are more destroyed in CAPD patients than in prediatytic patients, and in HD and CAPD pa¬tients than in healthy individuals, and this defect was partially improved by rEPO use.
Bookmark/Search this post with
Abstract (Original Language): 
Primer konak savunmasında önemli olan nötrofıl kemotaksis ve fagositozunun KBYde bozulduğu bilin¬mektedir. Rekombinant insan eritropoietini (rE-PO)'nin lökosit fagositozunu düzelttiği daha önce saptanmıştır. Ancak, nötrofillerin kemotaksis va spontan migrasyonu üzerine rEPO'nun etkisi ile ilgili veriler yetersizdir. Bu nedenle, hem KBY hastalarında diyali¬zin nötrofıl kemotaksisi ve spontan migrasyonu üzeri¬ne, hem de rEPO'nun diyaliz hastalarında nötrofıl fonksiyonları üzerine etkisini değerlendirmek amacı ile bu çalışmayı yaptık. On hemodiyaliz (HD; 1. grup), 12 sürekli ayaktan periton diyalizi (SAPD; 2. grup) hastası ve 7 kişi de konservatif tedavi uygulanan prediyalitik hasta (3.grup) olmak üzere toplam 29 KBYhastası çalışmaya alındı. Ayrıca 10 sağlıklı, gönüllü kişi kontrol grubu (4.grup) olarak alındı. Nötrofil kemotaksisi ve spontan migrasyonu Boyden-chamber yöntemi ile de¬ğerlendirildi. Hemoglobini 8.5 gl/dl'nin altında olan birinci gruptan altı ve 2.gruptan üç olmak üzere top¬lam dokuz hastaya (5. grup) rEPO lOOü/kg/haflada 3 gün, sc, 30 gün uygulandı. Beşinci grupta 1., 7. ve 30. günlerde nötrofıl kemotaksisi ve spontan migrasyonu tekrar çalışıldı. Kemotaksis 2. grupta 3. gruba göre (p=0.03), 1. ve 2. grupta ise 4. gruba göre anlamlı şekilde (p= 0. 0009, p=0.0002) daha düşüktü. Spontan migrasyon 1. ve 2.grupta 4. gruba göre anlamlı olarak (p=0.0,4, p=0.01 ) düşüktü. Beşinci grupta kemotaksis 7.gün l.güne göre (p=0.01), 3O.gün ise bazal ve l.güne göre anlamlı şekilde (p=0.02, p=0.02) daha yüksekti. Bu çalışmanın sonuçlan, SAPD hastalarında nöt-rofil fonksiyonlarının prediyalitik hastalara göre, hem HD hem de SAPD hastalarında ise sağlıklı bireylere göre anlamlı derecede bozuk olduğunu ve rEPO teda¬visi ile bunların kısmen düzeldiğini göstermektedir.
FULL TEXT (PDF): 
PDF icon pdf_tndt_160.pdf
  • 1-2
20-25
  • Turkish

REFERENCES

References: 

1. Raymond V, Severin R, Annemieke D, et al. Phagoctosis in uremic and hemodialysis patiants. A prospective and cross sectional study. Kidney Int 1991; 39:320-7.
2. Lewis S L. Van Epps D E, Chenoweth D E. Alterations in chemotactic factor induced responses of neutrophils and monocytes from chronic dialysis patients. Clin Nephrology 1988;30:63-72.
3. Lewis S L, Van Epps D E. Neutrophil and monocyte alte-
24
rations in chronic dialysis patients. Am J Kidney Dis 1987;9:331-95.
4. Pederson J O, Knudsen P, Jersild C. Acute effect of he-modialysis on neutrophil migration: Impact on humoral and cellular function. Kidney Int 1988;63 (suppl 2):S86-9.
5. Van Holder R, Ringoir S. Polymorphonuclear cell functi¬on and infection in dialysis. Kidney Int 1992; 42 (suppl 3): 531-5.
6. Tolkoff-Rubin N E, Rubin R H. Uremira and host defen¬ses. N Engl J Med 1990: 322: 770-2.
7. Huttenen K, Lampainen E, Silvennoinen-Kassienen S et al. The neutrophil function of uremic patients treated by hemodialysis or CAPD. Scand J Urol Nephrol 1984;18:167-72.
j Wandall J M. Neutrophilic granulocyte function. Dan
Med Bull 1988;35:237-52.
9. Lespier Dexter L E, Guerra C, Ojeda V, Martmez-Maldo-rado M. Granulocyte adherence in uremia and hemodialy-
sis. Nephron 1979;24:64-8.
10. Greene W H, Ray C, Mauen S M, Quire P G: The effect
of hemodialysis on neutrophil chemotactic responsive¬ness. J Lab Clin Med 1976;88:971-4.
11. Wierusz-Wysocka B, Wysocki H, Czanecki R, Siekierka H, Baczyk K. Wysocki K. Influence of hemodialysis on plasma chemotactic activity and the chemotactic responsi¬veness of polymorphonuclear neutrophils. Artif Organs 1983; 7:159-62.
12. Pederson J O, Knudsen F, Nielsen A H, Grunnet N. The ability of uremic serum to induce neutrophil chemotaxis in relation to hemodialysis. Blood Purif 1987;5;24-8.
13. Paczek L, Schaefer R M, Heidtand A. Improved function of B lymphocytes in dialysis petients treated by recombi-nant hurman erythropoietin. Contrib Nephrol 1990;87:38-41.
14. Sennesaet J J, Van Der Niepen P, Verbeelen D L. Treat¬ment with recombinant human erthropoietin increases an¬tibody titers after hepatitis B vaccination in dialysis pati¬ents. Kidney Int 1991:40:121-8.
15. Cases A, Escolar G, Reverter J C et at. Recombinant hu¬man erythropoietin improves platelet function in uremic
patients. Kidney int 1992;42:668-72.
16. Kimball P M, Kerman R H. Erythropoietin: A potential immunomodulator? Transplantation Proc 1991;23:336.
17. Kimata H, Yoshida A, Ishioka G, Mikawa H. Erythropoi-etin enhances immunoglobulin production and proliferati-
n by human plasma cells in a serum-free medium. Clin Immunol Immunopathol 1991: 59: 495-501.
18. Raska K, Raskova J, Shea S et al. T cell subsets and cellu¬lar immunity in end-stage renal disease. Am J Med
1988;75:734-40.
19. Weissgarten J, Modai D, Cohen N et al. Induction of sup-ressor cells in normal lymphocytes by uremic serum. Int
Archs Allergy Immunl986;81 :188-3.
20. Ruiz P, Gomez F, Schreiber A D. Impaired function of macrophage Fc receptors in end-stage renal disease. N
Engl. J Med 1990;322:717-22.
21. Hoy W E, Cestero R V M, Freeman R B. Deficiency of T and B lymphocytes in uremic subjects and partial impro¬vement with maintenance hemodialysis. Nephron 1978; 20:182-8.
22. Jacobs A A , Ward R A, Wellhausen S R, Leish K R.
Polymorphonuclear leukocyte function during hemodialy-sis: Relationship to complement activation. Nepron 1989;
52:119-24.
23. Hakim R M. Clinical sequelae of complement activation in hemodialysis. Clin Nephrology 1986;26:9-12.
24. Schauer S, Stein G, Suss J, Falkenhagen D, Linb W. Pha¬gocytosis activity of polymorphonuclear cells of normal persons and dialysis patients is influenced by different di¬alysis membranes. Nephrol Dal Transplant 1991;3:35-40.
25. Briggs W A, Pedersen M M, Mahajan S K et al.
Lymphocyte and granulocyte function in zinctreated anz zinc-deficient hemodialysis patients. Kidney Int
1982;21:827-32.
26. Spertini O, Luscinskas F W, Kansas G S et al. Leukocyte adhesion molecule-1 (LAM-1, L-selectin) interacts with an inducible endothelial cell ligand to support leukocyte adhesion. J Immun 1991: 147:2565-73.
27. Himmelfarb J, Zaoui P, Hakim R et al. Modulation of gra-nulocyte LAM-1 and MAC-1 during dialysis-A prospecti¬ve, randomized controlled trial. Kidney Int 1992;41:388-95.
28. Snyderman R, Goetzl E J. Molecular and cellular mecha¬nism of leukocyte chemotaxis. Science 1981;213:830-6.
29. Pfaffl W, Gross H J, Neumeier D, Nattermann U, Samtle-
ben W, Gurland H J. Lymphocyte subsets and delayed cu¬taneous hypersensitivity in hemodialysis patients recei¬ving recombinant human erythropoietin. Contrib Neprol
1988; 66:195;204.
30. Sperschneider H, Neumann K, Ruffert K, Stein G. Influ¬ence of recombinant human erythropoietin therapy on in vivo chemotaxis and in vitro phagocytosis of polymorp-honuclear cells of hemodialysis patients. Blood Purif 1996:14:157-64.
31. Wahlberg J, Jacobson J, Odling B, Tufveson G, Wikstorm B. Haemodilution in renal transplantation in patients on
erythropoietin. Lancet 1988;11:1418.

Thank you for copying data from http://www.arastirmax.com