透析膜和内毒素对单个核细胞白细胞介素—1受体拮抗物产生的协同作用

目的：研究不同透析膜和内毒素对尿毒素对尿毒症患者外周血单个核细胞（PBMC）白细胞介素－1受体拮抗物（IL－1Ra）基因转录和IL－1Ra合成的影响。方法：细胞和不同透析膜孵育后采用细胞原位杂交检测mRNA水平，PBMC培养后采用酶联免疫吸附试验法测定细胞IL－1Ra水平。结果：不同析膜孵育后的PBMC在未用内毒素刺激情况下IL－1RamRNA水平有显著判别，但IL－1Ra合成量无差异。其中正常人仅有极微量IL－1Ra合成；内毒素刺激下的PBMC IL－1Ra合成明显明显高于未刺激组，与铜仿膜孵育后的合成量明显高于聚砜膜孵育后和对照组。结论：内毒素和透析膜对正常人和尿毒症患者PBMC的IL－1Ra的合成协同作用。

Synergetic Effect of Dialyzer Membrane and LPS on Peripheral Blood Mononuclear Cells Intrerleukin-1 Receptor Antagonist Production

Purpose To investigate the effect of LPS and dialyzer membrane on interleukin 1 receptor antagonist (IL 1Ra) gene expression and protein production in uremic patients on continuous ambulatory peritoneal dialysis (CAPD),on regular hemodialysis (HD) and healthy controls. Methods IL 1Ra production by cultured peripheral blood mononulear cells (PBMC) after exposure to cuprammonium (Cup) membrane,polysulfone (PS) membranes or endotoxin was detected using ELISA.IL 1Ra nRNA expression was determine simultneously by in situ hybridiztion. Results In the absence of endotoxin,a small amount of IL? 1Ra is produced by PBMC harvested from patients or healthu controls after incubation with Cup or PS during subsequent 24 hour culture.Although no differences could be found in protein synthesis between Cup and PS, in situ hybridization showed that Cup induced markedly higher level mRNA coding for IL? 1Ra.In contrast,when subsequently stimulated with LPS,PBMC incubated with Cup could produce significantly larger amount IL? 1Ra compared with either unsitmulated or PS? incubated cells.LPS? stimulated PBMC in healthy subjects produced markedly lower IL? 1Ra as compared with uremic patients on HD or CAPD. Conclusions Bioincompatibility membrane and LPS have a synergetic effect on IL 1Ra production in uremic patients on HD or CAPD and in healthy subjects.