Interleukin-1 receptor antagonist among chronic renal failure pediatric patients with and without hemodialysis

ABSTRACT

During hemodialysis [HD], human blood leucocytes in circulation are exposed to several extraneous challenges, thus stimulated to secrete many inflammatory cytokines and its inhibitors as inter-leukin-1 and interieukin-1 receptor antagonist [IL-Ira]. The aim of this study was to investigate difference in the level of IL-IRa synthesis by peripheral blood mononuclear cells [PBMC] between CRF patients under conservative treatment and CRF patients under hemodialysis, and if this cytokine-specific inhibitory protein of PBMC can be used as a marker of dialysis related morbidity. The study included 44 subjects divided into 3 groups [A] control group, [B] Chronic renal failure[CRF] under conservative treatment, [C] CRF under HD. Peripheral blood mononuclear cells [PBMC] were separated by ficoll-Hypaque. Spontaneous and Phytohemagglutinin [PHA] stimulated total IL-1Ra synthesis [cell-associated and secreted] by cultured PBMC was measured using EL-ISA method. The results of the study revealed that there were significant spontaneous total IL-IRa synthesis by PBMC in dialysis patients [group C] 2812 +/- 836 and in patients with conservative treatment [group B] 1791.2 +/- 252 compared to control group [group A] 940 +/- 227.8 [P value <0.001]. There were significant spontaneous total IL-IRa synthesis by PBMC in dialysis patients [group C] 2812 +/- 836 compared to patients with conservative treatment [group B] 1791.2 +/- 252 [P value <0.001]. There were significant PHA stimulated total IL-IRa synthesis by PBMC in dialysis patients [group C] 34041 +/- 8906 and in patients with conservative treatment [group B] 8565 +/- 1244 compared to control group [group A] 2980 +/- 608 [P value <0.001]. There were significant PHA stimulated total IL-IRa synthesis by PBMC in dialysis patients [group C] 34041 +/- 8906 compared to patients with conservative treatment [group B] 8565 +/- 1244 [P value <0.001]. There was positive correlation between PHA stimulated total synthesis of ILIRa and spontaneous total synthesis of ILIRa by PBMC in the 3 groups [P value <0.001]. There was significant correlation between IL-IRa [spontaneous and stimulated] with blood pressure, urea and creatinine level [P value <0.001]. This study concluded that PBMC of CRF patients synthesize significant level of IL-IRa compared to PBMC of healthy subjects. Also, PBMC of CRF patients on HD synthesize significant level of IL-IRa compared to PBMC of CRF under conservative treatment. Lastly, IL-IRa synthesis by PBMC of CRF patients was correlated with blood urea, serum creatinine and blood pressure level