title: Study of association between interleukin-17 and interferon-gamma and recombinant human erythropoietin dose in patients undergoing peritoneal dialysis.
abstract: A common complication in patients undergoing peritoneal dialysis (PD) is a chronic inflammatory state and anemia that can be treating by recombinant human erythropoietin (rHuEPO). Higher required dose of rHuEPO could be expected in patients with higher cytokine levels. Additionally, it is known that peritoneal inflammation can be correlated with systemic inflammation and this could contribute to the compromised rHuEPO required dose in anemic patients with end stage renal disease (ESRD). Thus, the current study aimed to evaluate the association between levels of systemic and local interferon (IFN)-γ, interleukin (IL)-17 and other cytokines and the dose of rHuEPO used by patients undergoing PD for the correction of anemia.
  
  
  
  Thirty-one patients under PD using rHuEPO were evaluated in this cross-sectional study. Plasma and dialysate levels of IL-2, IL-4, IL-6, IL-10, IL-17, tumour necrosis factor (TNF)-α and IFN-γ were determined using the Cytometric Bead Array TM kit (CBA; BD Bioscences, San Jose, CA). The relation between the levels of each cytokine levels and the tertiles of rHuEPO were plotted on box-plot graphics and then the medians of interleukins levels were compared by median comparison test. The significance level adopted was 5% and the analysis was performed by the softwares STATA (version 12.0) and GraphPad Prism 3.0.
  
  
  
  The median of IL-17 and IFN-γ plasma levels were significant higher in the group with higher rHuEPO dosage. However, this association was not observed in the dialysate levels, as well as was not observed a relationship between the other plasma and dialysate cytokines evaluated in this study and the dose of rHuEPO.
  
  
  
  Our study found increased IL-17 and IFN-γ plasma, but no dialysate levels, in patients receiving higher doses of rHuEPO, suggesting may exist a relationship between systemic inflammation of ESRD, and the necessary levels of rHuEPO for the correction of anemia in these patients.
authors.affiliation: Campus Centro Oeste - Federal University of Sao Joao del Rei, Brazil.
authors.forename: Wander Valadares
authors.initials: WV
authors.lastname: de Oliveira
authors.affiliation: Campus Centro Oeste - Federal University of Sao Joao del Rei, Brazil.
authors.forename: Roberta Carvalho
authors.initials: RC
authors.lastname: de Figueiredo
authors.affiliation: Department of Clinical and Toxicological Analysis, Faculty of Pharmacy - Federal University of Minas Gerais, Brazil.
authors.forename: Adriano Sabino
authors.initials: AS
authors.lastname: de Paula
authors.affiliation: Campus Centro Oeste - Federal University of Sao Joao del Rei, Brazil.
authors.forename: Sylvia Dias
authors.initials: SD
authors.lastname: Turani
authors.affiliation: Campus Centro Oeste - Federal University of Sao Joao del Rei, Brazil.
authors.forename: Marina Souza Silva
authors.initials: MSS
authors.lastname: Velloso
authors.affiliation: Campus Centro Oeste - Federal University of Sao Joao del Rei, Brazil.
authors.forename: Melina Barros
authors.initials: MB
authors.lastname: Pinheiro
authors.affiliation: Department of Clinical and Toxicological Analysis, Faculty of Pharmacy - Federal University of Minas Gerais, Brazil.
authors.forename: Karina Braga
authors.initials: KB
authors.lastname: Gomes
authors.affiliation: Center of Nephrology - Hospital São João de Deus, Brazil.
authors.forename: Maria Aparecida Silva
authors.initials: MAS
authors.lastname: Marinho
authors.affiliation: Center of Nephrology - Hospital São João de Deus, Brazil.
authors.forename: Sérgio Wyton Lima
authors.initials: SWL
authors.lastname: Pinto
authors.affiliation: Campus Centro Oeste - Federal University of Sao Joao del Rei, Brazil. Electronic address: danyelleromana@gmail.com.
authors.forename: Danyelle Romana Alves
authors.initials: DRA
authors.lastname: Rios
mesh_terms: D000368:Aged; D000740:Anemia / Q000188:drug therapy / Q000209:etiology; D003430:Cross-Sectional Studies; D016207:Cytokines / Q000097:blood; D004305:Dose-Response Relationship, Drug; D004921:Erythropoietin / Q000008:administration & dosage* / Q000235:genetics / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007249:Inflammation / Q000188:drug therapy; D007371:Interferon-gamma / Q000097:blood*; D020381:Interleukin-17 / Q000097:blood*; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000009:adverse effects*; D051436:Renal Insufficiency, Chronic / Q000188:drug therapy
chemical_list: D016207:Cytokines; C508717:IL17A protein, human; D020381:Interleukin-17; D004921:Erythropoietin; D007371:Interferon-gamma
keywords: Chronic disease anemia; Chronic inflammation; Chronic kidney disease; Cytokines; Erythropoietin