血液透析および持続携行式腹膜透析患者の末梢血単核球におけるTNF-α, IL-1βおよびIL-6遺伝子発現

Abstract

Inflammatory cytokines, including TNF-alpha, IL-1 beta and IL-6, have been reported to be responsible for acute or chronic complications and biocompatibility issues in dialysis patients have focused on the role of these cytokines. Expression of mRNA for TNF-alpha, interleukin (IL)-1 beta and IL-6 in peripheral blood mononuclear cells (PBMC) and their plasma concentrations was examined in 10 hemodialysis and 10 continuous ambulatory peritoneal dialysis (CAPD) patients. Plasma TNF-alpha and IL-1 beta levels in hemodialysis, CAPD and in every healthy subject were below the detection limits. Plasma IL-6 concentration was increased significantly in hemodialysis and CAPD patients when compared to normal controls (p < 0.01). Expression of mRNA for TNF-alpha, IL-1 beta and IL-6 in PBMCs was increased significantly (p < 0.01) in hemodialysis and CAPD patients compared to normal subjects. These mRNA expressions were lower in CAPD patients than in hemodialysis patients (p < 0.05). Significant correlation was observed between the plasma IL-6 concentration and PBMC IL-6 mRNA expression in patients on hemodialysis or CAPD (p < 0.01). IL-6 mRNA expression in PBMCs did not correlate with the duration of hemodialysis or CAPD, blood urea nitrogen (BUN) or serum creatinine levels. These findings suggest that mRNA expression indicates stimulation by dialysis procedures in patients, and CAPD is tolerated better than hemodialysis by patients with end-stage renal failure.