title: Molecular biology-based assessment of vitamin E-coated dialyzer effects on oxidative stress, inflammation, and vascular remodeling.
abstract: Cardiovascular disease represents the most common cause for the excess of morbidity and mortality found in end-stage renal disease (ESRD) and has prompted the exploration of multiple approaches to improve outcomes in these patients. Cardiovascular risk factors such as increased oxidative stress (OxSt) and inflammation are found in ESRD patients. A vitamin E-coated dialyzer using polysulfone membranes has been suggested to have positive effects on these factors. This 1-year study evaluated in 25 ESRD patients under chronic dialysis, the effects of a vitamin E-coated membrane (VitabranE ViE) "ex vivo" on mononuclear cells, OxSt, and inflammation-related biochemical and molecular biology markers using a molecular biology approach. p22(phox), heme oxygenase (HO)-1, plasminogen activator inhibitor (PAI)-1 protein level, and phosphorylated extracellular signal-regulated kinase (pERK)1/2 status were evaluated at the beginning of the study, after 6 months and after 12 months by Western blot analysis and oxidized low-density lipoprotein (OxLDL) plasma level by enzyme-linked immunosorbent assay, alongside vascular remodeling assessment as measured by carotid intima-media thickness (IMT) in a subgroup of nine randomly selected patients. p22(phox), PAI-1, OxLDL, and pERK all decreased with VitabranE use, while HO-1 increased. Carotid IMT did not increase. Treatment with VitabranE significantly decreases the expression of proteins and markers relevant to OxSt and inflammation tightly associated with cardiovascular disease, and it appears highly likely that VitabranE use will provide a benefit in terms of cardiovascular protection.
authors.affiliation: Department of Clinical and Experimental Medicine, University of Padova-Azienda Ospedaliera di Padova, Padova, Italy. renzcalo@unipd.it
authors.forename: Lorenzo A
authors.initials: LA
authors.lastname: Calò
authors.forename: Agostino
authors.initials: A
authors.lastname: Naso
authors.forename: Angela
authors.initials: A
authors.lastname: D'Angelo
authors.forename: Elisa
authors.initials: E
authors.lastname: Pagnin
authors.forename: Marco
authors.initials: M
authors.lastname: Zanardo
authors.forename: Massimo
authors.initials: M
authors.lastname: Puato
authors.forename: Mirka
authors.initials: M
authors.lastname: Rebeschini
authors.forename: Silvano
authors.initials: S
authors.lastname: Landini
authors.forename: Mariano
authors.initials: M
authors.lastname: Feriani
authors.forename: Angelo
authors.initials: A
authors.lastname: Perego
authors.forename: Andrea
authors.initials: A
authors.lastname: Malagoli
authors.forename: Riccardo
authors.initials: R
authors.lastname: Zagatti
authors.forename: Piergianni
authors.initials: P
authors.lastname: Calzavara
authors.forename: Carmelo
authors.initials: C
authors.lastname: Cascone
authors.forename: Paul A
authors.initials: PA
authors.lastname: Davis
mesh_terms: D000328:Adult; D000975:Antioxidants / Q000494:pharmacology*; D002339:Carotid Arteries / Q000000981:diagnostic imaging; D020099:Coated Materials, Biocompatible / Q000494:pharmacology*; D048049:Extracellular Signal-Regulated MAP Kinases / Q000276:immunology; D005260:Female; D051547:Heme Oxygenase-1 / Q000276:immunology; D006801:Humans; D007963:Leukocytes, Mononuclear / Q000187:drug effects; D008077:Lipoproteins, LDL / Q000378:metabolism; D008297:Male; D008567:Membranes, Artificial; D008875:Middle Aged; D019255:NADPH Oxidases / Q000276:immunology; D018384:Oxidative Stress / Q000187:drug effects; D017395:Plasminogen Activator Inhibitor 1 / Q000276:immunology; D006435:Renal Dialysis / Q000009:adverse effects / Q000295:instrumentation*; D014463:Ultrasonography; D014810:Vitamin E / Q000494:pharmacology*
chemical_list: D000975:Antioxidants; D020099:Coated Materials, Biocompatible; D008077:Lipoproteins, LDL; D008567:Membranes, Artificial; D017395:Plasminogen Activator Inhibitor 1; C099252:oxidized low density lipoprotein; D014810:Vitamin E; D051547:Heme Oxygenase-1; D019255:NADPH Oxidases; C086986:CYBA protein, human; D048049:Extracellular Signal-Regulated MAP Kinases