title: [The antioxidant therapy modulates intracellular lymphokine expression in children on dialysis].
abstract: 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.
authors.affiliation: Klinika Kardiologii i Nefrologii Dzieciecej, Akademii Medycznej w Poznaniu. mzaniew@poczta.wp.pl
authors.forename: Marcin
authors.initials: M
authors.lastname: Zaniew
authors.forename: Jacek
authors.initials: J
authors.lastname: Zachwieja
authors.forename: Maria
authors.initials: M
authors.lastname: Lewandowska-Stachowiak
authors.forename: Dariusz
authors.initials: D
authors.lastname: Sobczyk
authors.forename: Aldona
authors.initials: A
authors.lastname: Siwińska
mesh_terms: 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*
chemical_list: D000975:Antioxidants; D015850:Interleukin-6; D008222:Lymphokines; D014810:Vitamin E; D015847:Interleukin-4; D007371:Interferon-gamma; D000111:Acetylcysteine