Von Willebrand factor and autoantibodies against oxidized LDL in hemodialysis patients treated with vitamin E-modified dialyzers.
Oxidant stress is a well known cause of damage in the atherosclerotic process. Vitamin E is one of the most promising natural antioxidants. In this study we investigated if a vitamin E-coated dialyzer was able to reduce the plasma levels of auto-antibodies against oxidized-LDL, von Willebrand factor (vWf) and thrombomodulin (TM) as markers of endothelial damage. In this controlled 6-month prospective study, we investigated these markers in two matched groups (n=16 each) of patients on regular hemodialysis not yet diagnosed for atherosclerosis cardiovascular disease (ACVD) (mean age=58.3+/-7.0 yrs, mean dialysis age=30.1+/-10.0 months), in which cellulosic (CLS) and vitamin E-modified dialyzers (CLE) were compared. At inclusion all the patients were treated with CLS. Then, the study group was shifted to CLE for 6 months. At baseline the patients showed normal levels of vitamin E and high levels of oxLDL-Ab, vWf and TM compared to healthy subjects. In the CLE group oxLDL-Ab and vWf, but not TM levels, decreased progressively (from 472+/-287 to 264+/-199 mU/mL, p<0.0001 and from 101.1+/-7.5% to 76.7+/-18.5%; p<0.001, respectively), and vitamin E increased from 4.40+/-0.81 to 7.81+/-1.16 microg/mg of cholesterol. At the end of the study, 8 of the patients treated with CLE were randomly selected and went back to the membrane without Vitamin E for six months. They showed an significant increase in OxLDL-Ab and vWf levels and a significant reduction in tocoferol levels. In conclusion, CLE compared to cellulosic dialyzers can lower some indices of damage to LDL and endothelial cells.
Bufano
G
G
Division of Nephrology and Dialysis, Cremona Hospital, Italy. giuseppe_bufano@yahoo.it
Usberti
M
M
Mandolfo
S
S
Malberti
F
F
Piroddi
M
M
Galli
F
F
D000328:Adult; D000975:Antioxidants / Q000494:pharmacology*; D001323:Autoantibodies / Q000096:biosynthesis*; D008078:Cholesterol, LDL / Q000276:immunology; D018849:Controlled Clinical Trials as Topic; D003430:Cross-Sectional Studies; D042783:Endothelial Cells / Q000187:drug effects; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy; D008567:Membranes, Artificial; D008875:Middle Aged; D018384:Oxidative Stress / Q000502:physiology; D011446:Prospective Studies; D006435:Renal Dialysis / Q000295:instrumentation*; D018180:Thrombomodulin / Q000276:immunology; D014810:Vitamin E / Q000494:pharmacology*; D014841:von Willebrand Factor / Q000096:biosynthesis*
D000975:Antioxidants; D001323:Autoantibodies; D008078:Cholesterol, LDL; D008567:Membranes, Artificial; D018180:Thrombomodulin; D014841:von Willebrand Factor; D014810:Vitamin E