Since the finding of β2-microglobulin as a causal substance in the carpal tunnel syndrome of chronic hemodialysis patients, removal of β2-microglobulin has been performed using highly permeable dialysis membranes with larger pores. Such large-pore membranes tend to allow endotoxins (Et), harmful substances contained in dialysate, to enter blood. At present, as a countermeasure, Et-blocking filtration membranes are used to remove Et from dialysate. However, Et removal mechanism by these membranes has not been clarified yet. The objective of this study is thus to visualize distribution of fluorescence-labeled Et trapped inside the polyester-polymer alloy (PEPA) membrane, a widely used Et-blocking filtration membrane using a confocal laser scanning fluorescence microscope (CLSFM). Et were observed mainly in the outer skin layer of the hollow fiber, while some in the void and inner skin layers. No Et were present inside the hollow fiber. In conclusion, we succeeded in visualization of Et distribution inside the Et-blocking filtration membrane using CLSFM. This novel visualization technique may allow evaluation of distribution of Et trapped inside various kinds of Et-blocking filtration membranes.
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