title: Endothelial progenitor cells and asymmetric dimethylarginine after renal transplantation.
abstract: Levels of the endogenous nitric oxide synthase inhibitor asymmetrical dimethylarginine (ADMA) are elevated and endothelial progenitor cells (EPCs) decreased in patients undergoing renal transplantation (Tx) and may contribute to cardiovascular complications. In this study, we tested the hypothesis that elevated ADMA and decreased EPC can be positively influenced with regular physical exercise early after Tx. Blood samples for analysis of ADMA and EPC were obtained from randomly selected 64 patients after Tx who agreed to participate in a supervised aerobic exercise program for 6 months (group I). Samples were collected before the training began, 1 month after surgery (with stabilized renal function), and at 6 months after initiation. Sixty-two age, sex, human leukocyte antigens (HLA) typing, duration of previous dialysis, history of cardiovascular disease, and immunosupression regimen-matched transplant patients who did not exercise regularly were examined as controls (group II). There were no differences in ADMA levels and EPC count between both groups before the training program began. After 6 months of exercise, ADMA concentration in the group I decreased (3.50 ± 0.45 vs. 2.11 ± 0.35 μmol/L; P < .01) and was also lower comparing with group II (2.11 ± 0.23 vs. 3.25 ± 0.35 μmol/L; P < .01). In the same period, EPC cells increased from 2.085 ± 650 cells/mL versus 3.991 ± 560 cells/mL, P < .01 in group I; but in group II, changes were nonsignificant (P = .11). Blood lipids, HbA1c, insulin, and systolic blood pressure were also affected by the training program. Elevated ADMA level and decreased EPC count were significantly influenced by early regular exercise in patients after Tx.
authors.affiliation: Department of Nephrology, Transplant Centre, Institute for Clinical and Experimental Medicine, Prague, Czech Republic; Institute for Postgraduate Education, Prague, Czech Republic. Electronic address: vladimir.teplan@ikem.cz.
authors.forename: Vladimír
authors.initials: V
authors.lastname: Teplan
authors.affiliation: Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic.
authors.forename: Andrea
authors.initials: A
authors.lastname: Mahrová
authors.affiliation: Cardiovascular Research Centre, Institute for Clinical and Experimantal Medicíně, Prague, Czech Republic.
authors.forename: Ivana
authors.initials: I
authors.lastname: Králová-Lesná
authors.affiliation: Institute of Clinical Biochemistry and Hematology, Medical Faculty Charles University, Pilsen, Czech Republic.
authors.forename: Jaroslav
authors.initials: J
authors.lastname: Racek
authors.affiliation: Department of Internal Medicine, Medical Faculty, Ostrava University, Ostrava, Czech Republic.
authors.forename: Ivo
authors.initials: I
authors.lastname: Valkovský
authors.affiliation: Department of Nephrology, Transplant Centre, Institute for Clinical and Experimental Medicine, Prague, Czech Republic.
authors.forename: Milena
authors.initials: M
authors.lastname: Štollová
mesh_terms: D000328:Adult; D000368:Aged; D001120:Arginine / Q000031:analogs & derivatives* / Q000097:blood; D066026:Endothelial Progenitor Cells; D005081:Exercise Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control*; D011446:Prospective Studies
chemical_list: C487735:dimethylarginine; D001120:Arginine