Influence of haemodialysis and left ventricular failure on peripheral A(2A) adenosine receptor expression.
BACKGROUND
Haemodialysis (HD) sometimes accelerates left ventricular failure (LVF). As adenosine (ADO) is strongly implicated in cardiovascular functions, particularly via A(2A) receptor activation and as changes of peripheral A(2A) receptors mirror changes occurring in the cardiovascular system, we examined the influence of HD and LVF on both ADO plasma concentration and the expression of A(2A) receptors (i.e. Bmax, K(D) and mRNA amount) of peripheral blood mononuclear cells.


METHODS
This cross-sectional study included 61 chronic renal failure (CRF) patients: 41 without LVF (24 haemodialysed and 17 undialysed) and 20 with LVF (9 haemodialysed and 11 undialysed). Ten LVF patients without CRF and 10 healthy subjects were also examined.


RESULTS
(i) Bmax values of CRF patients without LVF were significantly decreased in undialysed patients compared with haemodialysed patients, and compared with controls (69 +/- 25 vs 98 +/- 33 vs 180 +/- 60 fmol/mg of protein, P < 0.05). Bmax values of CRF patients with LVF were lower in undialysed patients than in haemodialysed patients (60 +/- 27 vs 101 +/- 27 fmol/mg of protein, P < 0.05). Bmax values of LVF patients without CRF were lower than in controls (51 +/- 19 vs 180 +/- 60 fmol/mg of protein). (ii) A(2A) mRNA expression was increased in haemodialysed patients compared with controls (20.2 +/- 0.75 vs 17.6 +/- 1.3, P < 0.05). (iii) ADO plasma levels were high in haemodialysed patients and further increased during the HD sessions.


CONCLUSIONS
The number of A(2A) receptors was decreased by CRF with or without LVF. However, this decrease was less important in haemodialysed patients. The changes in peripheral A(2A) receptor expression suggest a significant inflammatory response to HD and heart or kidney failure. Whether these changes do reflect alterations in cardiomyocytes needs further investigation.
Carrega
Louis
L
FRE2738 CNRS/Université de la Méditerranée, Faculté de Médecine Nord, Bd P. Dramard, 13015 Marseille, France.
Fenouillet
Emmanuel
E
Giaime
Philippe
P
Charavil
Annie
A
Mercier
Laurence
L
Gerolami
Victoria
V
Berge-Lefranc
Jean-Louis
JL
Berland
Yvon
Y
Ruf
Jean
J
Saadjian
Alain
A
Dussol
Bertrand
B
Guieu
Regis
R
D000241:Adenosine / Q000097:blood; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D001806:Blood Urea Nitrogen; D002845:Chromatography; D003404:Creatinine / Q000097:blood; D003430:Cross-Sectional Studies; D005260:Female; D005612:Freeze Drying; D015870:Gene Expression; D006333:Heart Failure / Q000209:etiology* / Q000235:genetics / Q000503:physiopathology; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000235:genetics; D007676:Kidney Failure, Chronic / Q000097:blood / Q000150:complications / Q000628:therapy*; D007963:Leukocytes, Mononuclear / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012333:RNA, Messenger / Q000235:genetics*; D043705:Receptor, Adenosine A2A / Q000097:blood / Q000235:genetics*; D006435:Renal Dialysis; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012720:Severity of Illness Index; D013318:Stroke Volume / Q000502:physiology; D018487:Ventricular Dysfunction, Left / Q000150:complications* / Q000235:genetics / Q000503:physiopathology
D015415:Biomarkers; D012333:RNA, Messenger; D043705:Receptor, Adenosine A2A; D003404:Creatinine; D000241:Adenosine