Kidney International (1990) 37, 116–125; doi:10.1038/ki.1990.16
Influence of uremia and hemodialysis on circulating interleukin-1 and tumor necrosis factor 
Andre Herbelin1, Anh Thu Nguyen1, Johanna Zingraff1, Pablo Ureña1 and Beatrice Descamps-Latscha1
1INSERM U 25 and CNRS UA 122, INSERM U 90 Hôpital Necker, Paris, France
Correspondence: Dr Béatrice Descamps-Latscha, INSERM U25, Hôpital Necker, 161 rue de Sèvres, 75743, Paris Cedex 15, France.
Received 25 October 1988; Revised 11 May 1989; Accepted 24 July 1989.
Top of pageAbstract
Influence of uremia and hemodialysis on circulating interleukin-1 and tumor necrosis factor
. Interleukin-1 (IL-1) and tumor necrosis factor
(TNF
) were determined in the plasma of long-term hemodialysis (HD) patients and uremic (UR) patients undergoing their first dialysis session using either cellulosic (CUP) or synthetic (PAN-AN 69) membrane-equipped dialyzers. In long-term HD patients, plasma IL-1 and TNF
levels were significantly increased compared to their levels in normal subjects. During a single dialysis session, a significant increase in IL-1 but not in TNF
was observed. In not yet dialyzed UR patients, IL-1 plasma levels did not differ from those observed in normal subjects. By contrast, TNF
was found significantly increased although less than in long-term HD patients. During the first dialysis session, no significant increase was observed in the levels of either monokine. Lastly, regardless of the group of patients, no significant influence of the dialysis membrane could be detected, suggesting that the observed changes are not exclusively secondary to the activation of complement. Altogether, these results suggest that the passage of the blood through the extracorporeal dialysis circuit triggers the secretion of IL-1 and further exacerbates that of TNF
by monocytes. The presence of increased TNF
in the plasma of first-dialysis UR patients suggests that factors unrelated to dialysis contribute to the activation of monocytes in these patients. Lastly, the concomitant presence of IL-1 and TNF
in the plasma of long-term HD patients could be responsible for some of the clinical features observed in these patients, and provides strong evidence favoring the concept that HD can be assimilated to a recurrent acute-phase inflammatory response.
Top of pageReferences
- Dinarello CA, Mier JW: Current concepts: lymphokines. N Engl J Med 317:940–945, 1987 | PubMed | ChemPort |
- Ruddle NH: Tumor necrosis factor and related cytotoxins. Immunol Today 8:129–130, 1987
- Beutler B, Cerami A: Cachectin: more than a tumor necrosis factor. N Engl J Med 316:379–385, 1987 | PubMed | ChemPort |
- Oppenheim JJ, Kovacs EJ, Matsushima K, Durum SK: There is more than one interleukin 1. Immunol Today 7:45–56, 1986 | Article | ChemPort |
- Dinarello CA: Interleukin-1 and the pathogenesis of the acute phase response. N Engl J Med 311:1413–1418, 1984 | PubMed | ISI | ChemPort |
- Dinarello CA, Cannon JG, Mier JW, Bernheim HA, Lopreste G, Lynn DL, Love RN, Webb AC, Auron PE, Reuben RC, Rich A, Wolff SM, Putney SD: Multiple biological activities of human recombinant interleukin 1. J Clin Invest 77:1734–1739, 1986 | PubMed | ISI | ChemPort |
- Henderson LW, Koch KM, Dinarello CA, Shaldon S: Hemodialysis hypotension: The interleukin hypothesis. Blood Purif 1:3–8, 1983 | ChemPort |
- Descamps-Latscha B, Herbelin A, Nguyen AT, Uzan M, Zingraff J: Haemodialysis-membrane-induced phagocyte oxidative metabolism activation and interleukin-1 production. Life Support Syst 4:349–353, 1986
- Lonnemann G, Bingel M, Koch KM, Shaldon S, Dinarello CA: Plasma interleukin-1 activity in humans undergoing hemodialysis with regenerated cellulosic membranes. Lymphokine Res 6:63–70, 1987 | PubMed | ISI | ChemPort |
- Luger A, Kovarik J, Stummvoll HK, Urbanska A, Luger TA: Blood-membrane interaction in hemodialysis leads to increased cytokine production. Kidney Int 32:84–88, 1988
- Ziegler EJ: Tumor necrosis factor in humans. N Engl J Med 318:1533–1535, 1988
- Dinarello CA: The biology of interleukin 1 and comparison to tumor necrosis factor. Immunol Lett 16:227–232, 1987
- Le J, Vilcek J: Tumor necrosis factor and interleukin 1: Cytokines with multiple overlapping biological activities. Lab Invest 56:234–248, 1987 | PubMed | ISI | ChemPort |
- Oppenheim JJ, Matsushima K, Yoshimura T, Leonard EJ: The activities of cytokines are pleiotropic and interdependent. Immunol Lett 16:179–184, 1987
- Dinarello CA, Cannon JG, Wolff SM, Bernheim HA, Beutler B, Cerami A, Figari IS, Palladino MA, O'Connor JV: Tumor necrosis factor (cachectin) is an endogenous pyrogen and induces production of interleukin 1. J Exp Med 163:1433–1450, 1986 | Article | PubMed | ISI | ChemPort |
- Wankowicz Z, Megyeri P, Issekutz A: Synergy between tumour necrosis factor.
and interleukin-1 in the induction of polymorphonuclear leucocyte migration during inflammation. J Leukocyte Biol 43:349–356, 1988 - Okusawa S, Gelfand JA, Ikejima T, Connolly RJ, Dinarello CA: Interleukin 1 induces a shock-like state in rabbits. J Clin Invest 81:1162–1172, 1988 | PubMed | ISI | ChemPort |
- Lonnemann G, Van Der Meer JWM, Cannon JG, Dinarello CA, Koch KM, Granolleras C, Deschodt G, Shaldon S: Induction of tumor necrosis factor during extracorporeal blood purification. N Engl J Med 317:963–964, 1987 | PubMed |
- Waage A, Halstensen A, Espevik T: Association between tumour necrosis factor in serum and fatal outcome in patients with meningococcal disease. Lancet 1:355–357, 1987 | Article | PubMed | ISI | ChemPort |
- Maury CPJ, Teppo AM: Raised serum levels of cachectin/tumor necrosis factor.
in renal allograft rejection. J Exp Med 166:1132–1137, 1987 - Hanicki Z, Cichocki T, Komorowska Z, Sulowicz W, Smolenski O: Some aspects of cellular immunity in untreated and maintenance hemodialysis patients. Nephron 23:273–275, 1979
- Silverblatt FJ, Beaty HN, Petersdorf RG: The effect of uremia on the pyrogenic response of rabbits. Proc Soc Exp Biol Med 132:492–496, 1969
- Turnbull AJ, Kluger MJ, Cranston WI, Townsend Y: Are the kidneys involved in the removal of endogenous pyrogens in the rabbit? J Therm Biol 7:95–98, 1982
- Beaurain G, Naret C, Marcon L, Grateau G, Drueke T, Urena P, Nelson DL, Bach JF, Chatenoud L: In vivo T cell preactivation in chronic uremic hemodialyzed and non-hemodialyzed patients. Kidney Int (in press)
- Montgomerie JZ, Kalmanson GM, Guze LB: Leukocyte phagocytosis and serum bactericidal activity in chronic renal failure. Am J Med Sci 264:385–393, 1972
- Lespier-Dexter LE, Guerra C, Ojeda W, Martinez-Maldonado M: Granulocyte adherence in uremia and hemodialysis. Nephron 24:64–68, 1979
- Rhee MS, McGoldrick MD, Meuwissen HJ: Serum factor from patients with chronic renal failure enhances polymorphonuclear leukocyte oxidative metabolism. Nephron 42:6–13, 1986 | PubMed | ISI | ChemPort |
- Shaldon S: Future trends in biocompatibility aspects of hemodialysis and related therapies. Clin Nephrol 26:S13–S16, 1986
- Henderson LW, Chenoweth D: Biocompatibility of artificial organs: An overview. Blood Purif 5:100–111, 1987
- Chenoweth D, Cheung AK, Henderson LW: Anaphylatoxin formation during hemodialysis: Effects of different dialyzer membranes. Kidney Int 24:764–769, 1983 | PubMed | ChemPort |
- Nguyen AT, Lethias C, Zingraff J, Herbelin A, Naret C, Descamps-Latscha B: Hemodialysis membrane-induced activation of phagocyte oxidative metabolism detected in vivo and in vitro within microamounts of whole blood. Kidney Int 28:158–167, 1985 | PubMed | ISI | ChemPort |
- Betz M, Haensch GM, Rauterberg EW, Bommer J, Ritz E: Cuprammonium membranes stimulate interleukin 1 release and arachidonic acid metabolism in monocytes in the absence of complement. Kidney Int 34:67–73, 1988 | PubMed | ISI | ChemPort |
- Cannon JG, Dinarello CA: Increased plasma interleukin-1 activity in women after ovulation. Science 227:1247–1249, 1985 | PubMed | ChemPort |
- Ruuth E, Couillin I, Herbelin A, Praz F: Functional bioassays for B cell growth factors using polyclonally activated murine spleen B cells. Lymphokine Res 8:147–158, 1989
- Gearing AJH, Johnstone AP, Thorpe R: Production and assay of the interleukins. J Immunol Meth 83:1–27, 1985
- Zlotnik A, Ransom J, Frank G, Fischer M, Howard M: Interleukin 4 is a growth factor for activated thymocytes: Possible role in T-cell ontogeny. Proc Natl Acad Sci USA 84:3856–3860, 1987 | Article | PubMed | ChemPort |
- Le J, Fredrickson G, Reis LFL, Diamantstein T, Hirano T, Kishimoto T, Vilcek J: Interleukin 2-dependent and interleukin 2-independent pathways of regulation of thymocyte function by interleukin 6. Proc Natl Acad Sci USA 85:8643–8647, 1988
- Mosmann TR, Yokota T, Kastelein R, Zurawski SM, Arai N, Takebe Y: Species-specificity of T cell stimulating activities of IL 2 and BSF-1 (IL 4): Comparison of normal and recombinant, mouse and human IL 2 and BSF-1 (IL 4). J Immunol 138:1813–1816, 1987
- Ruff M, Gifford GE: Tumor necrosis factor, in Lymphokines, edited by Pick E, Academic Press, New York, 1981, 2, p. 235
- Mosmann T: Rapid colorimetric assay for cellular growth and survival: Application to proliferation and cytotoxicity assays. J Immunol Meth 65:55–63, 1983 | Article | ISI | ChemPort |
- Reuter A, Bernier J, Vrindts-Gevaert Y, Meuleman-Gathy R, Malaise M, Fiers W, Franchimont P: Production of interferon gamma by peripheral blood mononuclear cells from normal subjects and from patients with rheumatoid arthritis. Clin Exp Rheumatol (in press)
- Reuter A, Bernier J, Gysen P, Gevaert Y, Gathy R, Lopez M, Dupont G, Damas P, Franchimont P: A RIA for tumor necrosis factor (TNF
) and interleukin 1
(IL-1
) and their direct determination in serum, in Monokines and Other Non-lymphocytic Cytokines, edited by Powanda M, New York, Alan Liss Inc, 1988, pp. 377–381 - Bergström J, Wehle B: No change in corrected
2-microglobulin concentration after cuprophane haemodialysis. Lancet 1:628–629, 1987 | PubMed | ISI | ChemPort | - Haeffner-Cavailon N, Fischer E, Bacle F, Carreno MP, Maillet F, Cavaillon JM, Kazatchkine MD: Complement activation and induction of interleukin-1 production during hemodialysis. Contrib Nephrol 62:86–98, 1988
- Baud L, Oudinet JP, Bens M, Noe L, Etienne J, Ardaillou R: Production of tumor necrosis factor by rat mesangial cells in response to bacterial lipopolysaccharide. Kidney Int (in press)
- Lowry RP, Ruby ZH: Glomeruli of nephritic rats release tumor necrosis factor
and serine protease with cytotoxic activity. (abstract) Xth International Congress of Nephrology, July 26–31, London, p. 339, 1987 - Wiggins RC, Eldredge C, Kunkel S: Monokine production by glomeruli at different stages of crescent formation in the rabbit. (abstract) Xth International Congress of Nephrology, July 26–31, London, p. 368, 1987
- Tsujimoto M, Yokota S, Vilcek J, Weissmann G: Tumor necrosis factor provokes superoxide anion generation from neutrophils. Bioch Biophys Res Com 137:1094–1100, 1986
- Michie HR, Manogue KR, Spriggs DR, Revhaug A, O'Dwyer S, Dinarello CA, Cerami A, Wolff SM, Wilmore DW: Detection of circulating necrosis factor after endotoxin administration. N Engl J Med 318:1481–1486, 1988 | PubMed | ISI | ChemPort |
- Okusawa S, Dinarello CA, Yancey KB, Endres S, Lawley TJ, Frank MM, Burke JF, Gelfand JA: C5a induction of human interleukin 1. Synergistic effect with endotoxin or interferon-
. J. Immunol 139:2635–2640, 1987 | PubMed | ChemPort | - Okusawa S, Yancey KB, Van Der Meer JWM, Endres S, Lonnemann G, Hefter K, Frank MM, Burke JF, Dinarello CA, Gelfand JA: C5a stimulates secretion of tumor necrosis factor from human mononuclear cells in vitro. Comparison with secretion of interleukin 1
and interleukin 1
. J Exp Med 168:443–448, 1988 | Article | PubMed | ISI | ChemPort | - Haeffner-Cavaillon N, Cavaillon JM, Laude M, Kazatchkine MD: C3a (C3adesArg) induces production and release of interleukin 1 by cultured human monocytes. J Immunol 139:794–799, 1987 | PubMed | ChemPort |
- Bingel M, Lonnemann G, Koch KM, Dinarello CA, Shaldon S: Plasma interleukin-1 activity during hemodialysis: The influence of dialysis membranes. Nephron 50:273–276, 1988 | PubMed | ISI | ChemPort |
- Lonnemann G, Koch KM, Shaldon S, Dinarello CA: Studies on the ability of hemodialysis membranes to induce, bind, and clear human interleukin-1. J Lab Clin Med 112:76–86, 1988 | PubMed | ISI | ChemPort |
- Nisbeth U, Hallgren R, Eriksson O, Danielson BG: Endotoxemia in chronic renal failure. Nephron 45:93–97, 1987
- Maury CPJ, Teppo AM: Serum immunoreactive interleukin 1 in renal transplant recipients. Transplant 45:143–147, 1988
- Scuderi P, Sterling KE, Lam KS, Finley PR, Ryan KJ, Ray CG, Petersen E, Slymen DJ, Salmon SE: Raised serum levels of tumour necrosis factor in parasitic infections. Lancet 2:1364–1365, 1986 | PubMed | ChemPort |
- Elias JA, Gustilo K, Baeder W, Freundlich B: Synergistic stimulation of fibroblast prostaglandin production by recombinant interleukin 1 and tumor necrosis factor. J Immunol 138:3812–3816, 1987
- Nijsten MW, De Groot ER, Ten Duis HJ, Klasen HJ, Hack CE, Aarden LA: Serum levels of interleukin-6 and acute phase responses. Lancet 2:921, 1987 | PubMed | ISI | ChemPort |
- Kohase M, Henriksen-De Stephano D, May LT, Vilcek J, Sehgal PB: Induction of
2-interferon by tumor necrosis factor: A homeostatic mechanism in the control of cell proliferation. Cell 45:659–666, 1986 | Article | PubMed | ISI | ChemPort | - Content J, De Witt L, Poupart P, Opdenakker G, Van Damme J, Billiau A: Induction of a 26-kDa-protein mRNA in human cells treated with an interleukin-1-related, leukocyte-derived factor. Eur J Biochem 152:253–257, 1985 | Article | PubMed | ISI | ChemPort |
- Rothstein JL, Schreiber H: Synergy between tumor necrosis factor and bacterial products causes hemorrhagic necrosis and lethal shock in normal mice. Proc Natl Acad Sci USA 85:607–611, 1988 | Article | PubMed | ChemPort |