Abstract
Serial alterations of peripheral blood lymphocyte subpopulations and mitogen responses of lymphocytes during hemodialysis were studied to clarify the effects of hemodialysis on immune responses in vivo. Twenty patients undergoing hemodialysis treatment were subjected to our study. Four kinds of dialyzer membranes, cuprophane, cellulose acetate, PMMA (polymethyl methacrylate) and EVAL (ethylene vinyl alcohol), were used during the hemodialysis treatment. The results obtained were as follows: 1) Absolute counts of the lymphocytes were significantly decreased at 15min after the start of hemodialysis when the cellulose acetate membrane was used (p<0.05). 2) Percentages of OKT3 positive cells were significantly increased at 15min after the start of hemodialysis when the PMMA membrane was used (p<0.05), while none of the four membranes was found to have affected the OKT4/OKT8 ratio or OKB1 positive cells. 3) Percentages of OKM1 positive cells were significantly decreased at 15min after the start of hemodialysis when the cuprophane membrane was used (p<0.05). 4) Proliferative responses of the lymphocytes to PHA were significantly enhanced at 15min after the start of hemodialysis compared with those before hemodialysis when the cuprophane membrane was used (p<0.05), while they were not significantly enhanced when other membranes were used, although individual cases showed remarkable enhancement. 5) Comparison of the normal and low responders to PHA, revealed that the PHA responses of the lymphocytes in the low responder group particularly showed remarkable enhancement at 15min after the start of hemodialysis compared with those before hemodialysis (p<0.01). 6) In the low responder group, the decreased rate of OKM1 positive cells and the enhancement rate of PHA responses of the lymphocytes tended to be positively correlated, though this was not significant. From these results, it was suggested that the enhancement of the PHA responses of the lymphocytes at 15min after the start of hemodialysis was possibly caused by a decrease in suppressor monocytes.
