血透膜对白介素-1β、肿瘤坏死因子-α、白介素-6基因表达及血浆水平的影响  

INFLUENCE OF DIFFERENT DIALYSIS MEMBRANES ON PLASMA LEVELS AND GENE EXPRESSION OF INTERLEUKIN1β, TUMOR NECROSIS FACTORα AND INTERLEUKIN6

作　　者：余志远[1,2] 钱家麒[1,2] 戴慧莉[1,2] 陈诗书[1,2] 程枫 张庆怡[1,2] 赵涵芳[1,2] 黄佩文[1,2] 

机构地区：[1]上海第二医科大学附属仁济医院肾内科 [2]上海第二医科大学生化教研室分子生物学实验室

出　　处：《肾脏病与透析肾移植杂志》1997年第5期439-443,共5页Chinese Journal of Nephrology,Dialysis & Transplantation

基　　金：国家自然科学基金;上海市教委资助

摘　　要：目的：评价不同透析膜血液透析的生物相容性。方法：定量反转录多聚酶链反应、细胞原位杂交技术和酶联免疫吸附方法。结果：在分组设计与拉丁交叉设计中，ＩＬ－１β、ＴＮＦ－α及ＩＬ－６血浆水平无论铜仿膜、聚甲基丙烯酸甲酯膜（ＰＭＭＡ）或聚砜膜血透时各组间差异不明显（Ｐ值均＞０．０５）；ＩＬ－１β、ＴＮＦ－α与ＩＬ－６ｍＲＮＡ在正常人外周血单个核细胞中无表达，而尿毒症未透析患者和血透患者外周血单个核细胞中均有表达，其中血透者的表达水平明显高于尿毒症未透析患者。反转录多聚酶链反应和细胞原位杂交检测发现铜仿膜血透时各细胞因子基因表达水平均显著高于ＰＭＭＡ与聚砜膜（Ｐ＜０．００１），而ＰＭＭＡ与聚砜膜间无差异（Ｐ＞０．０５）。结论：尿毒症（未透析）及血透均可激活外周血单个核细胞。从细胞因子基因表达水平看，铜仿膜生物相容性较ＰＭＭＡ与聚砜膜差。作者认为这一方法在评价透析膜的生物相容性上优于血浆水平测定。OBJECTIVE To assess the biocompatibility of different dialysis membranes by their effects on gene expression and plasma levels of interleukin1β, tumor necrosis factorα and interleukin6 in hemodialysis patients.METHODOLOGY This study included 22 regularly hemodialyzed patients who were dialyzed with cuprophane (CU) or PMMA or polysulphone(PS) dialyser. And 11 predialysis uremic patients (serum creatinine between 444～1468 μmol/L) and 10 healthy volunteers were included as the disease control and normal control. RTPCR, cellular in situ hybridization and ELISA were used to measure IL1β, TNFα and IL6 plasma levels and gene expression in peripheral blood mononuclear cells (PBMCs).RESULTS There was no difference in the plasma levels of IL1β, TNFα and IL6 among patients dialyzed with cuprophane (CU), or PMMA or polysulphone (PS) membranes, neither in the group design study nor in the Latin crossover design study(all P<005). By using RTPCR and cellular in situ hybridization, IL1β,TNFα and IL6 mRNA were detected in hemodialysis patients and predialysis uremic patients, while not in healthy volunteers. Plasma levels of IL1β,TNFα and IL6 mRNA were significantly increased in the hemodialysis patients than in the predialysis uremic patients. The levels of gene expression of IL1β, TNFα and IL6 were significantly higher in patients using CU dialyser than in patients using PMMA or PS dialyser(P<0001,P<0005 and P<005, respectively). No difference was found between patients using PMMA and PS dialyser (all P>005).CONCLUSION Enhanced gene expression and the increased plasma levels of IL1β, TNFα and IL6 were found in hemodialysis patients. Patients dialyzed with CU membrane had a lesser activation of the cytokines as compared to those with PMMA and PS membranes, suggesting CU membrane is more biocompatible. Measuring the gene expression of cytokines in PBMCs is a better means for the eva

关 键 词：血液透析 细胞因子 白细胞介素 肿瘤坏死因子 

分 类 号：R459.5[医药卫生—治疗学]