Association between malnutrition, integrin expression and impaired granulocyte adhesion in chronically hemodialyzed patients.
BACKGROUND
The relationship between malnutrition in hemodialysis (HD) patients with a chronic inflammatory condition and the expression levels of leukocyte integrins and their adhesiveness to fibronectin was investigated.


METHODS
Subjective global assessment, albumin and body mass index were used as nutritional markers to group malnourished (MP) and eutrophic (EP) patients. C-reactive protein was used as an inflammation marker. LFA-1, VLA-4 and VLA-5 expression levels on circulating leukocytes before and after HD were flow cytometrically measured; and their adhesiveness, through immobilized fibronectin.


RESULTS
MPs showed significantly higher VLA-5 expression on granulocytes, when compared with healthy individuals (HPs) as controls (13.7% +/- 2.3% vs. 5.0% +/- 1.1%; p=0.005), particularly after HD (25.8% +/- 4.1%; p<0.001). They also presented a significantly lower ability to adhere to fibronectin when compared with EPs, before HD (48.8% +/- 1.5% vs. 62.3% +/- 0.7%; p<0.001) and after HD (50.6% +/- 1.2% vs. 65.7% +/- 1.4%; p<0.0001). Increased numbers of circulating immature neutrophils were observed only in MPs.


CONCLUSIONS
Although presenting higher VLA-5 expression, malnutrition in HD patients is associated with impairment of the adhesive capacity of circulating leukocytes, particularly younger neutrophils, which may contribute to the chronic inflammatory status of these patients.
Pharmaceutical Sciences Postgraduate Program, Federal University of Paraná, Curitiba - Brazil.
Carla
C
Corradi-Perini
Miguel C
MC
Riella
Rosana I S I
RI
Cattaneo
Almeriane M
AM
Weffort-Santos
D000328:Adult; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism; D016022:Case-Control Studies; D002448:Cell Adhesion; D002908:Chronic Disease; D005260:Female; D005353:Fibronectins / Q000378:metabolism; D006098:Granulocytes / Q000276:immunology*; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000276:immunology*; D018836:Inflammation Mediators / Q000097:blood; D039041:Integrin alpha4beta1 / Q000378:metabolism; D039081:Integrin alpha5beta1 / Q000378:metabolism; D016023:Integrins / Q000378:metabolism*; D007674:Kidney Diseases / Q000097:blood / Q000150:complications / Q000276:immunology / Q000628:therapy*; D016169:Lymphocyte Function-Associated Antigen-1 / Q000378:metabolism; D008297:Male; D044342:Malnutrition / Q000097:blood / Q000276:immunology*; D008875:Middle Aged; D006435:Renal Dialysis / Q000009:adverse effects; D012709:Serum Albumin / Q000378:metabolism; D016896:Treatment Outcome
D015415:Biomarkers; D005353:Fibronectins; D018836:Inflammation Mediators; D039041:Integrin alpha4beta1; D039081:Integrin alpha5beta1; D016023:Integrins; D016169:Lymphocyte Function-Associated Antigen-1; D012709:Serum Albumin; D002097:C-Reactive Protein