[The antioxidant therapy modulates intracellular lymphokine expression in children on dialysis].
Oxidative stress (SOX) is believed to be responsible for functional disabilities of lymphocytes in end-stage renal disease (ESRD). Therefore, we investigated the effect of antioxidant therapy with vitamin E and N-acetylcysteine (NAC) on SOX and cytokine synthesis in T cells in dialyzed children. Eighteen children (aged 2-20, mean 10.9 yr) treated with hemodialysis (n=5) and peritoneal dialysis (n=13) were enrolled into the study. Vitamin E and NAC were given orally for six months. Throughout the study, intracellular lymphokines [interleukin (IL)-2, interferon (IFN)-gamma, IL-4, IL-6] and SOX in T cells were measured by means of flow cytometry. In dialyzed children, mean fluorescence intensity (MFI), which reflected intracellular SOX, was significantly higher than in the controls in both CD3+ and CD3+CD4+ cells (p<0.05). We also found a cytokine dysregulation with a trend toward a predominant T helper (Th)-1 response compared to the controls. After 6 months of treatment with antioxidants, a significant reduction in MFI was noted compared to baseline values in CD3+ and CD3+CD4- cells (p<0.001). Interestingly, the therapy led to a decrease in IFN-gamma as well as an increase in IL-4 and IL-6 production. In addition, a gradual decline in IFN-gamma/IL-4 ratio in Th cells was noted.


CONCLUSIONS
Vitamin E and NAC used in combination are effective in reducing the intracellular SOX, and besides their action on cellular redox state, they modulate the cytokine profile in children on dialysis.
Zaniew
Marcin
M
Klinika Kardiologii i Nefrologii Dzieciecej, Akademii Medycznej w Poznaniu. mzaniew@poczta.wp.pl
Zachwieja
Jacek
J
Lewandowska-Stachowiak
Maria
M
Sobczyk
Dariusz
D
Siwińska
Aldona
A
D000111:Acetylcysteine / Q000494:pharmacology / Q000627:therapeutic use*; D000293:Adolescent; D000328:Adult; D000975:Antioxidants / Q000494:pharmacology / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D007371:Interferon-gamma / Q000378:metabolism; D015847:Interleukin-4 / Q000096:biosynthesis; D015850:Interleukin-6 / Q000096:biosynthesis; D007676:Kidney Failure, Chronic / Q000378:metabolism* / Q000628:therapy*; D008222:Lymphokines / Q000097:blood / Q000187:drug effects*; D008297:Male; D018384:Oxidative Stress / Q000187:drug effects; D010530:Peritoneal Dialysis / Q000009:adverse effects; D011044:Poland; D006435:Renal Dialysis / Q000009:adverse effects; D013601:T-Lymphocytes / Q000378:metabolism*; D016896:Treatment Outcome; D014810:Vitamin E / Q000494:pharmacology / Q000627:therapeutic use*
D000975:Antioxidants; D015850:Interleukin-6; D008222:Lymphokines; D014810:Vitamin E; D015847:Interleukin-4; D007371:Interferon-gamma; D000111:Acetylcysteine