A randomized prospective cross over study on the effects of medium cut-off membranes on T cellular and serologic immune phenotypes in hemodialysis.
Journal
Scientific reports
ISSN: 2045-2322
Titre abrégé: Sci Rep
Pays: England
ID NLM: 101563288
Informations de publication
Date de publication:
30 09 2022
30 09 2022
Historique:
received:
27
05
2022
accepted:
19
09
2022
entrez:
30
9
2022
pubmed:
1
10
2022
medline:
5
10
2022
Statut:
epublish
Résumé
Extended cut-off filtration by medium cut-off membranes (MCO) has been shown to be safe in maintenance hemodialysis (HD). The notion of using them for the control of chronic low-grade inflammation and positively influencing cellular immune aberrations seems tempting. We conducted an open label, multicenter, randomized, 90 day 2-phase cross over clinical trial (MCO- vs. high flux-HD). 46 patients underwent randomization of which 34 completed the study. Dialysate- or pre- and post-dialysis serum inflammatory mediators were assayed for each study visit. Ex vivo T cell activation was assessed from cryopreserved leucocytes by flow cytometry. Linear mixed models were used to compare treatment modalities, with difference in pre-dialysis serum MCP-1 levels after 3 months as the predefined primary endpoint. Filtration/dialysate concentrations of most mediators, including MCP-1 (mean ± SD: 10.5 ± 5.9 vs. 5.1 ± 3.8 pg/ml, P < 0.001) were significantly increased during MCO- versus high flux-HD. However, except for the largest mediator studied, i.e., YKL-40, this did not confer any advantages for single session elimination kinetics (post-HD mean ± SD: 360 ± 334 vs. 564 ± 422 pg/ml, P < 0.001). No sustained reduction of any of the studied mediators was found neither. Still, the long-term reduction of CD69+ (P = 0.01) and PD1+ (P = 0.02) activated CD4+ T cells was striking. Thus, MCO-HD does not induce reduction of a broad range of inflammatory mediators studied here. Long-term reduction over a 3-month period was not possible. Increased single session filtration, as evidenced by increased dialysate concentrations of inflammatory mediators during MCO-HD, might eventually be compensated for by compartment redistribution or increased production during dialysis session. Nevertheless, lasting effects on the T-cell phenotype were seen, which deserves further investigation.
Identifiants
pubmed: 36180564
doi: 10.1038/s41598-022-20818-z
pii: 10.1038/s41598-022-20818-z
pmc: PMC9524345
doi:
Substances chimiques
Cephalosporins
0
Chitinase-3-Like Protein 1
0
Dialysis Solutions
0
Inflammation Mediators
0
Membranes, Artificial
0
MCO
56369-20-1
Types de publication
Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
16419Informations de copyright
© 2022. The Author(s).
Références
J Immunol. 1993 Sep 15;151(6):3261-6
pubmed: 8376778
Nephrol Dial Transplant. 2020 Feb 1;35(2):328-335
pubmed: 31578564
Kidney Int. 2010 Jan;77(2):141-51
pubmed: 19907414
PLoS One. 2017 Jan 13;12(1):e0169024
pubmed: 28085888
J Infect. 1991 May;22(3):251-7
pubmed: 1830073
Contrib Nephrol. 2017;191:32-43
pubmed: 28910789
Kidney Int. 2020 Dec;98(6):1540-1548
pubmed: 32979369
Arterioscler Thromb Vasc Biol. 2007 Apr;27(4):929-35
pubmed: 17255538
Semin Dial. 2007 Sep-Oct;20(5):440-51
pubmed: 17897251
Nat Rev Nephrol. 2020 Oct;16(10):573-585
pubmed: 32733095
Sci Rep. 2020 May 8;10(1):7780
pubmed: 32385307
J Am Soc Nephrol. 2017 Jan;28(1):359-367
pubmed: 27413076
J Am Soc Nephrol. 2009 Jul;20(7):1641-9
pubmed: 19389855
Blood Purif. 2020;49(6):733-742
pubmed: 32634815
Clin Exp Immunol. 2005 May;140(2):343-8
pubmed: 15807860
Kidney Int. 2018 Jan;93(1):221-230
pubmed: 28941940
Blood Purif. 2020;49(4):468-478
pubmed: 31968346
Sci Rep. 2015 Dec 16;5:18448
pubmed: 26669756
J Am Soc Nephrol. 2011 Mar;22(3):437-42
pubmed: 21310819
Toxins (Basel). 2021 Mar 29;13(4):
pubmed: 33805509
Clin J Am Soc Nephrol. 2018 Jan 6;13(1):91-99
pubmed: 29242373
Nephrol Dial Transplant. 2021 Jul 23;36(8):1555-1556
pubmed: 34046683
Clin J Am Soc Nephrol. 2020 Sep 7;15(9):1310-1319
pubmed: 32843372
Kidney Int. 2010 Mar;77(6):550-6
pubmed: 20016471
Immunology. 2010 Apr;129(4):474-81
pubmed: 20201977
Semin Dial. 2022 Sep;35(5):436-439
pubmed: 35293638
Nat Rev Immunol. 2015 Aug;15(8):486-99
pubmed: 26205583
Nephron Clin Pract. 2006;102(2):c51-8
pubmed: 16224196
Front Immunol. 2020 Sep 29;11:583702
pubmed: 33117396
Nat Rev Nephrol. 2021 Dec;17(12):788-789
pubmed: 34635831
Adv Med Sci. 2013;58(2):311-9
pubmed: 23959669
Cell Immunol. 2021 May;363:104313
pubmed: 33631404
J Am Coll Cardiol. 2018 May 29;71(21):2405-2414
pubmed: 29793629
Sci Rep. 2021 Jul 20;11(1):14768
pubmed: 34285273
Kidney Int. 2021 Jul;100(1):182-195
pubmed: 33359055
Clin Kidney J. 2019 Nov 11;14(1):382-389
pubmed: 33564442
BMJ Open. 2020 Feb 5;10(2):e033228
pubmed: 32029487
Clin J Am Soc Nephrol. 2015 Feb 6;10(2):232-40
pubmed: 25492254
BMC Nephrol. 2020 Jul 13;21(1):271
pubmed: 32660510
Ren Fail. 2017 Nov;39(1):547-554
pubmed: 28726529