透析膜生体適合性評価におけるHPLCによる血清ネオプテリン測定の有用性 : ビタミンE固相化改質セルロース膜における基礎的・臨床的評価

Abstract

Exposure of blood to hemodialysis membranes results in numerous phenom- ena or complications in hemodialysis (HD) patients, and these complications influence the quality of life (QOL) in HD patients. Vitamin E coated cellulose dialyzer (E-membrane) is developed to act as scavenger for reactive oxgen species which couse complications in HD patients. Neopterin (NEOP) is the metabolites derived from guanosine triphosphate. Recently it was shown that production and release of NEOP is induced in monocyte and macrophages by cytokines such as interferon gamma (IFN-γ). And it is surmised to be as a reactive marker of biocompatibility of dialysis membrane in hemodialyzed patients. In this study, we evaluated the usefulness of serum NEOP as a marker for biocompatibility of dialyzer by the use of E-membrane and control membrane in experimen- tal and clinical study. In experimental study in using dogs, exracorporal circulation with E-membrane and control membrane, the serial levels of serum NEOP in dogs using E- membrane were lower than those of control membrane about the ratio of serum NEOP. In clinical study, during extracorporal ultrafiltration methods (ECUM), the levels of serum NEOP in patients using E-membranes were lower than those in patients using control membranes. In long time evaluation of biocompatibility of there two membranes, the ratio of increasing of serum NEOP using control membranes was higher than that using E- membranes. By evaluation of serum NEOP for biocompatibility of membrane in dialysis, our observa- tion showed that serum NEOP is useful as a marker of biocompatibility in hemodialysis membrane.