Nephrol Dial Transplant (1995) 10: 2077-2082
© 1995 European Renal Association-European Dialysis and Transplant Association
research-article
Expression of inflammatory cytokines and adhesion molecules in haemodialysis-associated amyloidosis
1Division of Immunological Diseases, Medical Research Institute, Tokyo Medical and Dental University Tokyo, Japan 2R&D Division, Mitsubishi Kagaku BCL Tokyo, Japan 3Division of Pharmacology, Cancer Research Institute, Kanazawa University Kanazawa, Japan 4Tokatsu Clinic Hospital Chiba, Japan 5First Department of Medicine, School of Medicine, Tokyo Medical and Dental University Japan
Correspondence and offprint requests to: Correspondence and offprint requests to: Nobuyuki Miyasaka MD, First Department of Medicine, School of Medicine, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, Japan
BACKGROUND.: The occurrence of various arthropathies including carpal-tunnel syndrome (CTS) in dialysis-associated amyloidosis, a condition caused by the deposition of ß2 microglobulin (ß2MG), has been emphasized for several years. We attempted to analyse the pathogenesis of CTS in haemodialysis-associated amyloidosis (HA).
METHODS.: The expression of cell adhesion molecules and inflammatory cytokines in tenosynovial tissues was determined by using both reverse-transcriptase polymerase chain reaction (RT-PCR) and immunostaining.
RESULTS.: There was a marked expression of ICAM-1, VCAM-1, E-selectin mRNAs together with increased mRNA expression of inflammatory cytokines (IL-1ß, TNF
, IL-6 and MCP-1) in proliferating synovial tissues. ICAM-1 was expressed not only on vascular endothelial cells, but also on synovial cells. In contrast, both VCAM-1 and E-selectin were exclusively expressed on endothelial cells. Mononuclear cells bearing CD13, CD14, CD33 and HLA-DR with macrophage-like morphology were accumulated in the perivascular area and expressed VLA-4, LFA-1 and Mac-1. Moreover, synovial lining cells, vascular endothelial cells and infiltrated mononuclear cells expressed chemokines such as MCP-1 and MIP-1.
CONCLUSIONS.: These data suggest that upregulated expression of inflammatory cytokines and adhesion molecules promotes activation and infiltration of macrophages causing CTS in haemodialysis-associated amyloidosis patients.
Keywords: carpal-tunnel syndrome; ß2-microglobulin; cytokine; cell adhesion molecule; monocyte/macrophage
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