Cell-associated adhesion molecules as early markers of bioincompatibility

BACKGROUND.: Transient nature of adhesive interactions occurring during cellmargination is mainly dependent on expression of selectins whichare shed by activated cells. This shedding in the circulationmay play an important role as anti-inflammatory mediator. Haemodialysisis also associated with P-selectin (CD62P)/sialyl-Lewisx (CD15s)interactions which mediate platelet-leukocyte coaggregation.We further investigated the mechanisms underlying leukocytemargination during haemodialysis. METHODS.: CD15s, CD11b and CD61 expression on circulating leukocytes frompatients dialysed on synthetic membranes (modified polyacrylonitrile(SPAN), polysulphone (PS), and polyacrylonitrile (AN69) wasassessed by cytofluorometry in a prospective crossover trial.We measured plasma levels C3a/C3a desArg, soluble CD62P, andCD62E molecules obtained from patients and healthy individuals. RESULTS.: Expression of CD11b and CD15s was upregulated on neutrophilsfrom patients dialysed with SPAN and PS membranes during thedialysis session. A significant negative correlation was foundbetween the expression of CD11b or CD15s molecules and neutrophilcounts as well as between CD15s expression and monocyte countsduring haemodialysis. As assessed by CD61 expression on leukocytes,we observed that platelets bound significantly onto both neutrophilsand monocytes during dialysis with both membranes. A significantpositive correlation was found between the expression of CD11bmolecules and the percentage of CD61 ⁺ monocytes counts duringSPAN and PS dialysis. We found a significant increase of solubleCD62P in plasma samples obtained from haemodialysed patientsbefore the dialysis session as compared to the levels detectedin plasma from healthy individuals. CONCLUSIONS.: This study documents a major role of CD15s, CD11b, CD61, CD62Pmolecules in the transient leukocytes activation and marginationduring haemodialysis on synthetic membranes despite their lowcomplement-activating properties.