title: New Insight into Atherosclerosis in Hemodialysis Patients: Overexpression of Scavenger Receptor and Macrophage Colony-Stimulating Factor Genes.
abstract: BACKGROUND
  Scavenger receptors (SRs) play a pivotal role in atherogenesis. The mechanism of atherosclerosis, which is specific to hemodialysis (HD) patients, was studied on the basis of SR gene expressions.
  
  
  METHODS
  The gene expressions of SR type A (SR-A) and CD36 were studied in peripheral monocytes by real-time reverse transcription polymerase chain reaction. Data were compared between HD (n = 30) and age-matched control subjects (n = 10). Serum levels of macrophage colony-stimulating factor (M-CSF) were measured with enzyme-linked immunosorbent assay to test its role in SR expression. The statistical differences and associations between two continuous variables were assessed using the Mann-Whitney U test and Pearson's correlation coefficient, respectively.
  
  
  RESULTS
  The relative quantities of SR mRNAs were significantly greater in HD patients than in controls [median (interquartile range): SR-A, 1.67 (0.96-2.76) vs. 0.90 (0.60-1.04), p = 0.0060; CD36, 1.09 (0.88-1.74) vs. 0.74 (0.64-0.99), p = 0.0255]. The serum concentration of M-CSF was significantly higher in HD patients than in controls [1, 121 (999-1,342) vs. 176 (155-202) pg/ml, p < 0.0001]. In addition, the relative quantity of M-CSF mRNA was significantly greater in HD patients than in controls [0.79 (0.42-1.53) vs. 0.42 (0.28-0.66), p = 0.0392]. The serum M-CSF levels were positively correlated with both the relative quantity of SR-A mRNA (r2= 0.1681, p = 0.0086) and that of CD36 mRNA (r2= 0.1202, p = 0.0284) in all subjects (n = 40).
  
  
  CONCLUSIONS
  HD patients are predisposed to atherosclerosis as a consequence of their enhanced monocyte SR expressions. SRs and M-CSF are potential therapeutic targets for atherosclerosis in this high-risk population.
authors.affiliation: Fourth Department of Internal Medicine, Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: Miki
authors.initials: M
authors.lastname: Nishida
authors.affiliation: Fourth Department of Internal Medicine, Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: Minoru
authors.initials: M
authors.lastname: Ando
authors.affiliation: Fourth Department of Internal Medicine, Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Iwamoto
authors.affiliation: Fourth Department of Internal Medicine, Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: Ken
authors.initials: K
authors.lastname: Tsuchiya
authors.affiliation: Fourth Department of Internal Medicine, Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: Kosaku
authors.initials: K
authors.lastname: Nitta
keywords: Cardiovascular disease; Colony-stimulating factor-1 receptor; Macrophage colony-stimulating factor; Real-time reverse transcription polymerase chain reaction