Effect of 1-year oral alpha-tocopherol administration on anticardiolipin antibodies in hemodialysis patients.
BACKGROUND
Anticardiolipin antibodies (ACA) have been related to an increased incidence of thrombotic episodes and atherosclerosis progression. ACA levels are elevated in hemodialysis (HD) patients. Atheroembolic episodes are the major cause of morbidity and mortality in this population. Oxidative stress has been implicated in ACA formation, and it is increased in HD patients. Vitamin E is a known antioxidant factor. In this study, the effects of prolonged oral alpha-tocopherol administration on ACA levels were evaluated.


METHODS
Serum anticardiolipin IgG antibodies (ACA-IgG) and IgM antibodies (ACA-IgM) levels were evaluated in 27 stable HD patients and 22 healthy volunteers. Then measurements were performed in the patients' group after oral administration of alpha-tocopherol at a dose of 500 mg/d for a 1-year period. ACA levels were assessed by solid-phase enzyme immunoassay.


RESULTS
ACA-IgG levels were higher in HD patients compared with control (13.3 +/- 6.64 GPL/mL vs. 7.727 +/- 18.305 GPL/mL, p < .001). This was not the case for ACA-IgM levels (2.96 +/- 4.18 MPL/mL vs. 1.386 +/- 2.636 MPL/mL, p=.17). alpha-Tocopherol administration resulted in a further increase in ACA-IgG (26.7 +/- 14.7 GPL/mL vs. 13.3 +/- 6.64 GPL/mL, p < .001) and ACA-IgM levels (8.17 +/- 1.95 MPL/mL vs. 2.96 +/- 4.18 MPL/mL, p < .001) in HD patients.


CONCLUSIONS
Prolonged oral alpha-tocopherol administration in HD patients increases ACA levels. The mechanism and the clinical significance of this finding need further evaluation.
Antoniadi
Georgia
G
Department of Nephrology, General Hospital of Serres, Serres, Greece. elefthe@otenet.gr
Eleftheriadis
Theodoros
T
Liakopoulos
Vasilios
V
Kakasi
Eleni
E
Vayonas
Georgios
G
Kortsaris
Alexandros
A
Vargemezis
Vasilios
V
D000284:Administration, Oral; D017153:Antibodies, Anticardiolipin / Q000378:metabolism*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000378:metabolism; D007075:Immunoglobulin M / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D018384:Oxidative Stress; D006435:Renal Dialysis; D013997:Time Factors; D024502:alpha-Tocopherol / Q000008:administration & dosage / Q000627:therapeutic use*
D017153:Antibodies, Anticardiolipin; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D024502:alpha-Tocopherol