The relationship between eosinophilia and serum cytokine concentrations in maintenance hemodialysis patients

Park, Eun Mi; Kim, Hyang; Jung, Soo Suk; Yun, Jung Won; Koo, Eun Sil; Lee, Kyu Beck; Keum, Dong Keuk

Abstract

BACKGROUND: Eosinophilia in hemodialysis (HD) patients has been associated with allergic reactions to dialyzers and exaggerated activation of complement during HD. Complement activation can lead to cytokine production. The cause of the eosinophilia is controversial and maybe multifactorial. Eosinophilia is stimulated by T lymphocytes and maybe related to the immune dysfunction of uremic patients. The aim of this study is to elucidate the relationship between the eosinophilia and serum cytokine concentrations in maintenance HD patients and to reveal whether the eosinophilia in HD patients reflects HD-associated cytokine production.
METHODS
We examined 40 HD patients who were stable for a minimum of 3 months at our hemodialysis unit. We measured eosinophil count and eosinophil percent on peripheral blood smear. Eosinophilia was defined as >or=350 cells/mm3 or >or=5% on smear. The serum concentrations of Interleukin-1beta (IL-1beta), Interleukin-2 (IL-2), Interleukin-5 (IL-5), Interleukin-6 (IL-6) were measured by ELISA before (pre) and after (post) dialysis.
RESULTS
Thirteen patients with eosinophilia were compared 27 patients without eosinophilia. In patients with eosinophilia, serum concentrations of IL-1beta and IL-2 were significantly elevated after dialysis than before dialysis (p<0.05). Post-HD IL-6 concentrations also were elevated, but statistically insignificant. IL-5 concentrations were not elevated after dialysis. In patients without eosinophilia, serum concentrations of IL-1beta, IL-2 and IL-6 were significantly elevated after dialysis (p<0.05). IL-5 concentrations were not elevated after dialysis. The eosinophil counts were not correlated to age, gender, underlying disease, serum levels of blood urea nitrogen, creatinine, albumin, CRP and the levels of post dialysis cytokines.
CONCLUSION
Independently on eosinophilia in HD, the serum concentrations of cytokines (IL-1beta, IL-2 and IL-6) were elevated after HD. IL-5 concentrations were not elevated after dialysis. But we could not reveal whether the eosinophilia in maintenance HD patients may be a surrogate marker for the reflection of exaggerated cellular cytokine production during HD or not by this study.