Vitamin e-loaded membrane dialyzers reduce hemodialysis inflammaging

被引:28
作者
Sepe, Vincenzo [1 ,2 ]
Gregorini, Marilena [1 ,3 ]
Rampino, Teresa [1 ]
Esposito, Pasquale [1 ]
Coppo, Rosanna [4 ]
Galli, Francesco [5 ]
Libetta, Carmelo [1 ,3 ]
机构
[1] Fdn IRCCS Policlin San Matteo, Unit Nephrol & Dialysis, Transplantat, Viale Camillo Golgi 19, I-27100 Pavia, Italy
[2] Fdn IRCCS Policlin San Matteo, UOC Nefrol & Dialisi, Trapianto, Viale Camillo Golgi 19, I-27100 Pavia, Italy
[3] Univ Pavia, Chair Nephrol, Corso Str Nuova 65, I-27100 Pavia, Italy
[4] Regina Margherita Hosp, Fdn Ric Molinette, 94 Piazza Polonia, I-10126 Turin, Italy
[5] Univ Perugia, Pharmaceut Sci Branch, Via Giochetto,Bldg B,2nd Floor, I-06123 Perugia, Italy
关键词
Biocompatibility; Indoleamine; 2; 3-dioxygenase; Inflammaging; Nitric oxide; Vitamin E-loaded multi-layer hemodialysis filter; STAGE RENAL-DISEASE; NITRIC-OXIDE; DIALYSIS; COMPLEMENT; MICROENVIRONMENT; TRYPTOPHAN; CELLS;
D O I
10.1186/s12882-019-1585-6
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Background Inflammaging is a persistent, low-grade, sterile, nonresolving inflammatory state, associated with the senescence of the immune system. Such condition downregulates both innate and adaptive immune responses during chronic disorders as type II diabetes, cancer and hemodialysis, accounting for their susceptibility to infections, malignancy and resistance to vaccination. Aim of this study was to investigate hemodialysis inflammaging, by evaluating changes of several hemodialysis treatments on indoleamine 2,3-dioxygenase-1 activity and nitric oxide formation. Methods We conducted a randomized controlled observational crossover trial. Eighteen hemodialysis patients were treated with 3 different hemodialysis procedures respectively: 1) Low-flux bicarbonate hemodialysis, 2) Low-flux bicarbonate hemodialysis with vitamin E - loaded dialyzers, and 3) Hemodialfitration. The control group consisted of 14 hospital staff healthy volunteers. Blood samples were collected from all 18 hemodialysis patients just after the long interdialytic interval, at the end of each hemodialysis treatment period. Results Hemodialysis kynurenine and kynurenine/L - tryptophan blood ratio levels were significantly higher, when compared to the control group, indicating an increased indoleamine 2,3-dioxygenase-1 activity in hemodialysis patients. At the end of the low-flux bicarbonate hemodialysis with vitamin E - loaded dialyzers period, L - tryptophan serum levels remained unchanged vs both low-flux bicarbonate hemodialysis and hemodialfitration. Kynurenine levels instead decreased, resulting in a significant reduction of kynurenine/L - tryptophan blood ratio and indoleamine 2,3-dioxygenase-1 activity, when matched to both low-flux bicarbonate hemodialysis and HDF respectively. Serum nitric oxide control group levels, were significantly lower when compared to all hemodialysis patient groups. Interestingly, low-flux bicarbonate hemodialysis with vitamin E - loaded dialyzers nitric oxide serum levels from venous line blood samples taken 60 min after starting the hemodialysis session were significantly lower vs serum taken simultaneously from the arterial blood line. Conclusions The treatment with more biocompatible hemodialysis procedure as low-flux bicarbonate hemodialysis with vitamin E - loaded dialyzers, reduced indoleamine 2,3-dioxygenase-1 activity and nitric oxide formation when compared to both low-flux bicarbonate hemodialysis and hemodialfitration. These data suggest that low-flux bicarbonate hemodialysis with vitamin E - loaded dialyzers lowering hemodialysis inflammaging, could be associated to changes of proinflammatory signalling a regulated molecular level.
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页数:8
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