title: Long-term erythropoietin therapy does not affect metalloproteinases and their inhibitor levels, oxidative stress and inflammation in hemodialyzed patients.
abstract: BACKGROUND
  Matrix metalloproteinases (MMPs) and their tissue inhibitors (TIMPs) play an important role in the atherosclerosis. Recombinant human erythropoietin (EPO) has become widely used to treat anemic hemodialyzed (HD) patients; however, an increased mortality has been reported for HD patients with cardiovascular disease when randomly assigned to normal hematocrit by EPO. Therefore, we conducted a study examining the effect of EPO on MMPs/TIMPs system, oxidative stress and inflammation in these patients.
  
  
  METHODS
  Assessment of MMP-2, MMP-9, TIMP-1 and TIMP-2 were performed in 20 stable HD patients and 15 healthy controls. Additionally, the effects of EPO on malondialdehyde (MDA)--a marker of SOX and C-reactive protein (CRP) levels--as a marker of inflammation were also investigated. Of the 20 patients, 10 were receiving EPO therapy [HD-EPO(+)] for 12 months or more and 10 were not receiving EPO therapy [HD-EPO(-)]. Both groups were not receiving iron supplementation.
  
  
  RESULTS
  All parameters, with the exception of MMP-9, were lower in the healthy subjects compared with the HD subjects, irrespective of EPO administration. There was no difference in MMPs/TIMPs system, MDA and C-reactive levels between HD-EPO(+) and HD-EPO(-) patients.
  
  
  CONCLUSIONS
  Erythropoietin therapy did not influence MMPs/TIMPs system, inflammation, or SOX in a low-risk HD patient population, in the absence of concomitant iron supplementation and mean Hg levels within target.
authors: Department of Nephrology and Clinical Transplantation, Medical University, Bialystok, Poland.
authors: Krystyna
authors: K
authors: Pawlak
authors: Dariusz
authors: D
authors: Pawlak
authors: Michal
authors: M
authors: Mysliwiec
mesh_terms: D000328:Adult; D000368:Aged; D000740:Anemia / Q000188:drug therapy; D002097:C-Reactive Protein / Q000378:metabolism*; D016022:Case-Control Studies; D004921:Erythropoietin / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008315:Malondialdehyde / Q000097:blood; D045726:Metalloproteases / Q000097:blood / Q000187:drug effects*; D008875:Middle Aged; D018384:Oxidative Stress / Q000187:drug effects*; D006435:Renal Dialysis / Q000009:adverse effects*; D019714:Tissue Inhibitor of Metalloproteinases / Q000097:blood / Q000187:drug effects*; D014511:Uremia / Q000628:therapy
chemical_list: D019714:Tissue Inhibitor of Metalloproteinases; D004921:Erythropoietin; D008315:Malondialdehyde; D002097:C-Reactive Protein; D045726:Metalloproteases