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A novel bio-assay increases the detection yield of microbiological impurity of dialysis fluid, in comparison to the LAL-test

Griet Glorieux UGent, Eva Schepers UGent, Ralf Schindler, Horst-Dieter Lemke, Francis Verbeke UGent, Annemieke Dhondt UGent, Norbert Lameire UGent and Raymond Vanholder UGent (2009) NEPHROLOGY DIALYSIS TRANSPLANTATION. 24(2). p.548-554
abstract
Background. Biological purity of dialysis water is considered as one of the primary conditions to deliver optimal haemodialysis. Methods. The present study explores the added value of a novel cytokine (IL-1ß) induction assay, using a monocytic THP-1 cell line, compared to the classical detection methods for microbial dialysis fluid contaminants. Results. In contrast to the Limulus Amebocyte Lysate (LAL)-test, which only detects intact lipopolysaccharide (LPS), the THP-1 assay was also sensitive to peptidoglycan, short bacterial DNA fragments and LPS fragments <5 kD. The purity of 269 dialysis fluid samples was tested by the THP-1 assay and compared to the LAL-test. Two hundred and sixty samples complied with the definition of ‘pure’ dialysis fluid as laid down in the European Pharmacopeia (European Best Practice Guidelines for Hemodialysis. Section IV. Dialysis fluid purity. Nephrol Dial Transplant 2002; 17: 45–62) but 27 of these so-called pure dialysates (10.3%) provoked a pro-inflammatory response in the THP-1 assay. Furthermore, among the 230 samples that complied the definition of an ultrapure dialysis fluid, 21 samples (9.1%) were pro-inflammatory. These data illustrate that this novel bio-assay detects microbiological entities with an inflammatory potential that cannot be found by the classical LAL screening method. Conclusions. Adding this novel THP-1 assay to the classical methods will be helpful in the prevention of biofilm formation in the delivery system and should have relevance by more accurate detection of dialysate contamination, hence decreasing micro-inflammation in the haemodialysis patient.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (original)
publication status
published
keyword
haemodialysis, dialysis fluid quality, LAL-test, bio-assay
journal title
NEPHROLOGY DIALYSIS TRANSPLANTATION
Nephrol. Dial. Transplant.
volume
24
issue
2
pages
548 - 554
publisher
OXFORD UNIV PRESS, GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND
Web of Science type
Article
Web of Science id
000262525900035
JCR category
UROLOGY & NEPHROLOGY
JCR impact factor
3.306 (2009)
JCR rank
13/61 (2009)
JCR quartile
1 (2009)
ISSN
0931-0509
DOI
10.1093/ndt/gfn485
language
English
UGent publication?
yes
classification
A1
id
519399
handle
http://hdl.handle.net/1854/LU-519399
date created
2009-03-16 15:49:36
date last changed
2009-03-18 11:48:16
@article{519399,
  abstract     = {Background. Biological purity of dialysis water is considered as one of the primary conditions to deliver optimal haemodialysis. 

Methods. The present study explores the added value of a novel cytokine (IL-1{\ss}) induction assay, using a monocytic THP-1 cell line, compared to the classical detection methods for microbial dialysis fluid contaminants. 

Results. In contrast to the Limulus Amebocyte Lysate (LAL)-test, which only detects intact lipopolysaccharide (LPS), the THP-1 assay was also sensitive to peptidoglycan, short bacterial DNA fragments and LPS fragments {\textlangle}5 kD. The purity of 269 dialysis fluid samples was tested by the THP-1 assay and compared to the LAL-test. Two hundred and sixty samples complied with the definition of {\textquoteleft}pure{\textquoteright} dialysis fluid as laid down in the European Pharmacopeia (European Best Practice Guidelines for Hemodialysis. Section IV. Dialysis fluid purity. Nephrol Dial Transplant 2002; 17: 45--62) but 27 of these so-called pure dialysates (10.3\%) provoked a pro-inflammatory response in the THP-1 assay. Furthermore, among the 230 samples that complied the definition of an ultrapure dialysis fluid, 21 samples (9.1\%) were pro-inflammatory. These data illustrate that this novel bio-assay detects microbiological entities with an inflammatory potential that cannot be found by the classical LAL screening method. 

Conclusions. Adding this novel THP-1 assay to the classical methods will be helpful in the prevention of biofilm formation in the delivery system and should have relevance by more accurate detection of dialysate contamination, hence decreasing micro-inflammation in the haemodialysis patient.},
  author       = {Glorieux, Griet and Schepers, Eva and Schindler, Ralf and Lemke, Horst-Dieter and Verbeke, Francis and Dhondt, Annemieke and Lameire, Norbert and Vanholder, Raymond},
  issn         = {0931-0509},
  journal      = {NEPHROLOGY DIALYSIS TRANSPLANTATION},
  keyword      = {haemodialysis,dialysis fluid quality,LAL-test,bio-assay},
  language     = {eng},
  number       = {2},
  pages        = {548--554},
  publisher    = {OXFORD UNIV PRESS, GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND},
  title        = {A novel bio-assay increases the detection yield of microbiological impurity of dialysis fluid, in comparison to the LAL-test},
  url          = {http://dx.doi.org/10.1093/ndt/gfn485},
  volume       = {24},
  year         = {2009},
}

Chicago
Glorieux, Griet, Eva Schepers, Ralf Schindler, Horst-Dieter Lemke, FRANCIS VERBEKE, Annemieke Dhondt, Norbert Lameire, and Raymond Vanholder. 2009. “A Novel Bio-assay Increases the Detection Yield of Microbiological Impurity of Dialysis Fluid, in Comparison to the LAL-test.” Nephrology Dialysis Transplantation 24 (2): 548–554.
APA
Glorieux, G., Schepers, E., Schindler, R., Lemke, H.-D., VERBEKE, F., Dhondt, A., Lameire, N., et al. (2009). A novel bio-assay increases the detection yield of microbiological impurity of dialysis fluid, in comparison to the LAL-test. NEPHROLOGY DIALYSIS TRANSPLANTATION, 24(2), 548–554.
Vancouver
1.
Glorieux G, Schepers E, Schindler R, Lemke H-D, VERBEKE F, Dhondt A, et al. A novel bio-assay increases the detection yield of microbiological impurity of dialysis fluid, in comparison to the LAL-test. NEPHROLOGY DIALYSIS TRANSPLANTATION. OXFORD UNIV PRESS, GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND; 2009;24(2):548–54.
MLA
Glorieux, Griet, Eva Schepers, Ralf Schindler, et al. “A Novel Bio-assay Increases the Detection Yield of Microbiological Impurity of Dialysis Fluid, in Comparison to the LAL-test.” NEPHROLOGY DIALYSIS TRANSPLANTATION 24.2 (2009): 548–554. Print.