Longitudinal study of apoptosis in chronic uremic patients.
Uremia is associated with a state of immune dysfunction, increasing infection and malignancy rates. Dysregulation of homeostasis may be directly related to abnormal apoptosis regulation, a process which is crucial for the maintenance of the biologic system. Abnormal apoptosis rates (ARs) have been reported in the literature. We performed a longitudinal study over a 10-week period in three groups of uremic subjects-hemodialysis (HD), peritoneal dialysis (PD), and predialysis chronic renal failure (CRF). Our results showed that ARs were consistent over the observed period. Monocytes extracted from HD and CRF subjects had higher ARs compared to PD and controls (HD: 26.06 +/- 8.82; CRF: 26.96 +/- 12.81; PD: 14.77 +/- 5.87; C: 11.42 +/- 4.60) when placed in culture medium. The plasma of HD and CRF subjects when incubated with U937 cells had a stronger apoptogenic potential compared with PD and controls (HD: 26.08 +/- 11.39; CRF: 24.87 +/- 9.07; PD: 12.13 +/- 4.51; C: 11.69 +/- 4.02). Inflammatory markers (C-reactive protein [CRP], procalcitonin) and cytokines (interleukin [IL]-1beta, IL-2, IL-10) had a generally poor correlation except for tumor necrosis factor (TNF)-alpha (p < 0.001). The phagocytic ability of U937 cells when incubated with the various plasma demonstrated impaired response in the HD and CRF subjects (HD: 27.56 +/- 6.67; CRF: 30.24 +/- 9.08; PD: 36.55 +/- 9.80; C: 40.04 +/- 6.98). These results suggest continuous renal purification, such as in continuous ambulatory peritoneal dialysis (CAPD), may have advantages over intermittent therapies in regulating apoptosis and maintaining biologic function and homeostasis.
D'Intini
Vincenzo
V
Department of Nephrology, San Bortolo Hospital, Vicenza, Italy.
Bordoni
Valeria
V
Fortunato
Antonio
A
Galloni
Elisabetta
E
Carta
Mariarita
M
Galli
Francesco
F
Bolgan
Irene
I
Inguaggiato
Paola
P
Poulin
Sonya
S
Bonello
Monica
M
Tetta
Ciro
C
Levin
Nathan
N
Ronco
Claudio
C
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D017209:Apoptosis; D002097:C-Reactive Protein / Q000378:metabolism; D002116:Calcitonin / Q000378:metabolism; D015740:Calcitonin Gene-Related Peptide; D016022:Case-Control Studies; D053148:Caspase 3; D053181:Caspase 8; D020169:Caspases / Q000378:metabolism; D018929:Cell Culture Techniques; D016207:Cytokines / Q000378:metabolism; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis; D010587:Phagocytosis / Q000502:physiology; D011498:Protein Precursors / Q000378:metabolism; D006435:Renal Dialysis; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism; D014511:Uremia / Q000503:physiopathology* / Q000628:therapy
C000606589:CALCA protein, human; D016207:Cytokines; D011498:Protein Precursors; D014409:Tumor Necrosis Factor-alpha; D002116:Calcitonin; D002097:C-Reactive Protein; C505407:CASP3 protein, human; C505530:CASP8 protein, human; D053148:Caspase 3; D053181:Caspase 8; D020169:Caspases; D015740:Calcitonin Gene-Related Peptide