title: Overexpression of erythrocyte glutathione S-transferase in uremia and dialysis.
abstract: BACKGROUND
  Overexpression of glutathione S-transferase (GST; EC 2.5. 1.18) has been documented in the erythrocytes of patients with chronic renal failure, and this event may well be of relevance from a clinical standpoint. In fact, it could serve as a marker of uremic toxicity overall, which can contribute to impair the function and survival of the erythrocytes. However, the biochemical details of this phenomenon are poorly understood.
  
  
  METHODS
  In this study, we characterized the expression of GST in erythrocytes of 118 uremic patients under different clinical conditions. The mechanisms responsible for the regulation of protein expression and enzyme activity were investigated in light of different dialysis approaches, oxidative stress, uremic toxins, erythrocyte age, and erythropoietin (EPO) supplementation.
  
  
  RESULTS
  Mean GST activity in uremic patients was highly overexpressed with respect to controls, and this phenomenon was exclusively attributable to an increased expression of GST. Overexpression of GST did not appear to be dependent on oxidative stress and was not influenced by vitamin E supplementation. In the same manner, both erythrocyte age and EPO supplementation apparently did not interfere with the GST concentrations, which were the same in controls and patients. Preliminary experiments suggested that high-molecular weight or protein-bound toxins could play some role in the overexpression of GST.
  
  
  CONCLUSIONS
  GST expression may be a useful marker for the individual accumulation of uremic toxins as well as of the efficiency of new dialysis strategies in removing them.
authors.affiliation: "G. Fornaini" Institute of Biological Chemistry, University of Urbino, 2-61029 Urbino, Italy. galli@uniurb.it
authors.forename: F
authors.initials: F
authors.lastname: Galli
authors.forename: S
authors.initials: S
authors.lastname: Rovidati
authors.forename: S
authors.initials: S
authors.lastname: Benedetti
authors.forename: U
authors.initials: U
authors.lastname: Buoncristiani
authors.forename: C
authors.initials: C
authors.lastname: Covarelli
authors.forename: A
authors.initials: A
authors.lastname: Floridi
authors.forename: F
authors.initials: F
authors.lastname: Canestrari
mesh_terms: D015415:Biomarkers / Q000097:blood; D015153:Blotting, Western; D015314:Dialysis Solutions / Q000737:chemistry; D004912:Erythrocytes / Q000201:enzymology*; D004921:Erythropoietin / Q000494:pharmacology; D005227:Fatty Acids / Q000097:blood / Q000737:chemistry; D005260:Female; D005978:Glutathione / Q000097:blood; D005982:Glutathione Transferase / Q000378:metabolism*; D006801:Humans; D007700:Kinetics; D015227:Lipid Peroxidation; D008297:Male; D010531:Peritoneal Dialysis, Continuous Ambulatory; D006435:Renal Dialysis / Q000295:instrumentation; D014511:Uremia / Q000097:blood* / Q000628:therapy; D014810:Vitamin E / Q000097:blood
chemical_list: D015415:Biomarkers; D015314:Dialysis Solutions; D005227:Fatty Acids; D004921:Erythropoietin; D014810:Vitamin E; D005982:Glutathione Transferase; D005978:Glutathione