Mehmet Cagatay TASKAPAN, Fatma OZYALİN, Hulya TASKAPAN, Meltem DEMİR, Ali DOGAN

Thioredoxin reductase activity, serum IL6, HsCRP and NT-proBNP levels in patients on dialysis

Amaç: Sitokinler natriüretik petid sekresyonunda direk uyarıcı etkiye sahiptir. N terminal probeyin tip natriüretik peptid diyaliz hatalarının mortalitesinde önemli bir biyobelirteçtir. Bu çalışmanın amacı peritonel diyaliz(PD) ve hemodiyaliz(HD) hastalarında; tiyoredoksin redüktaz aktivitesi ile NT-proBNP, IL6 ve yüksek duyarlıklı C reaktif protein seviyelerini (HsCRP)karşılaştırmak ve aralarındaki ilişkiyi araştırmaktır. Gereç ve Yöntemler: Yaş ve cinsiyet değişkenlerine gore 30 HD, 30 PD ve 20 kontrol sağlıklı denek gruplara ayrılarak HsCRP, serum IL6, NT-proBNP seviyeleri ile tiyoredoksin redüktaz aktivitesi ölçüldü. Sonuç: HsCRP, serum IL6, NT-proBNP seviyeleri HD ve PD hastalarında kontrol grubuna kıyasla istatiksel olarak anlamlı derecede yüksek bulundu (p0,05), tiyoredoksin redüktaz aktivitesi 3 grupta da fark göstermedi. Ayrıca tiyoredoksin redüktaz aktivitesi çalışmadaki hiçbir parametre ile korelasyon göstermedi. HsCRP; BMI(r:0.275, p:0.034), IL6 (r:0.633, p:0.000), NT proBNP (r:0.277, p:0.032) ile pozitif korelasyon gösterirken, serum albumin konsantrasyonu ile negative korelasyon (r:-0.425, p:0.001) gösterdi. Serum IL6 seviyeleri HsCRP (r:0.633, p:0.000) ve BMI (r:0.775, p:0.034) ile pozitif, albumin ile negative (r:-0.342, p:0.007) korelasyon gösterdi. Serum NT-proBNP seviyeleri ise serum albumini ile negatif; yaş (r:0.315, p:0.002), HsCRP (r:0.277, p:0.032), sistolik (r:0.421, p:0.001) ve ortalama kan basıncı ile (r:0.311, p:0.015) ise pozitif korelasyon gösterdi.

Diyaliz hastalarında tiyoredoksin redüktaz aktivitesi, serum IL6, HsCRP ve NT-proBNP seviyeleri

Aim: Cytokines have a direct stimulating effect on natriuretic peptide secretion. N-terminal probrain type natriuretic peptide (NT-proBNP) is a valuable biomarker for mortality in dialysis patients. The aim of this study was to compare thioredoxin reductase, NT-proBNP, IL6 levels and high sensitive C reactive protein (HsCRP) in peritoneal dialysis (PD), and hemodialysis (HD) patients and investigate relationship among these parameters. Material and Methods:In age and sex matched 30 HD patients, in 30 PD patients and 20 healthy controls, HsCRP, thioredoxin reductase, serum IL6, and NT-proBNP levels were measured. Results: HsCRP, IL6 and NT-proBNP levels in HD and PD patients were significantly higher than in controls (p0.05). Thioredoxin reductase was not different in 3 groups (p>0.05). Thioredoxin reductase was not correlated with any studiedparameters. HsCRP levels were positively correlated with BMI (r:0.275, p:0.034), IL6 (r:0.633, p:0.000), and NT-proBNP (r:0.277, p:0.032), and negatively correlated with serum albumin levels (r:-0.425, p:0.001). Serum IL6 levels were positively correlated with HsCRP (r:0. 633 p:0.000), BMI (r:0.775, p:0.034) and negatively correlated with albumin (r:-0.342, p:0.007). Serum NT-proBNP levels were negatively correlated with serum albumin (r:-0.385, p:0.002), and positively correlated with age (r:0.315, p:0.002), HsCRP (r:0.277, p:0.032), systolic (r:0.421, p:0.001) and mean blood pressure (r:0.311, p:0.015). In multiple regression analyses the predictors of HsCRP were IL6 (?:0.677, p:0.000), the predictor of serum IL6 was HsCRP (?:0.677, p:0.000). The predictors of serum NT-proBNP levels were serum albumin (?:-0.416, p:0.000) and mean blood pressure (?:0.414, p:0.000). Conclusion: NT-proBNP levels are not related with IL6 levels and thioredoxin reductase in patients on dialysis

PDF

___

Wang AY, Lam CW, Wang M, Chan IH, Lui SF, Zhang Y, et al. Diagnostic potential of serum biomarkers for left ventricular abnormalities in chronic peritoneal dialysis patients. Nephrol Dial Transplant 2009;24(6):1962-69.
Bavbek N, Akay H, Altay M,Uz E, Turgut F, Uyar ME, et al. Serum BNP concentration and left ventricular mass in CAPD and automated peritoneal dialysis patients. Perit Dial Int 2007;27(6):663-8.
Wang AY, Lam CW, Yu CM,Wang M, Chan IH, Zhang Y, et al. N-terminal pro-brain natriuretic peptide: an independent risk predictor of cardiovascular congestion, mortality, and adverse cardiovascular outcomes in chronic peritoneal dialysis patients. J Am Soc Nephrol 2007;18(1):321-30.
Fagugli RM1, Palumbo B, Ricciardi D, Pasini P, Santirosi P, Vecchi L. peptide and extracellular water in haemodialysis patients. Nephron Clin Pract 2003;95(2):c60-6.
Stenvinkel P, Barany P, Heimbürger O, Pecoits-Filho R, Lindholm B. Mortality, malnutrition, and atherosclerosis in ESRD: what is the role of interleukin-6? Kidney Int Suppl 2002;80:103-8.
Roberts MA, Srivastava PM, Macmillan N, Hare DL, Ratnaike S, Sikaris K, et al. B-type natriuretic peptides strongly predict mortality in patients who are treated with long-term dialysis. Clin J Am Soc Nephrol 2008;3(4):1057-65.
Gutiérrez OM, Tamez H, Bhan I, Zazra J, Tonelli M, Wolf M, et al. N-terminal pro-B-type natriuretic peptide (NT- proBNP) concentrations in hemodialysis patients: prognostic value of baseline and follow-up measurements. Clin Chem 2008;54(8):1339-48.
Clerico A, Recchia FA, Passino C, Emdin M: Cardiac endocrine function is an essential component of the homeostatic regulation network: Physiological and clinical implications. Am J Physiol Heart Circ Physiol 2006;290(1):H17-29.
Chiurchiu V, Izzi V, D'Aquilio F, Carotenuto F, Di Nardo P, Baldini PM. Brain Natriuretic Peptide (BNP) regulates the production of inflammatory mediators in human THP-1 macrophages. Regul Pept 2008;148(1-3):26-32.
De Bold AJ. Cardiac natriuretic peptides gene expression and secretion in inflammation. J Investig Med 2009;57(1):29-32.
Shor R, Rozenman Y, Bolshinsky A, Harpaz D, Tilis Y, Matas Z,Y, et al. BNP in septic patients without systolic myocardial dysfunction. Eur J Intern Med 2006;17/8):536-40.
Packard RRS, Libby P: Inflammation in atherosclerosis: from vascular biology to biomarker discovery and risk prediction. Clin Chem 2008;54(1):24-38.
Arnér ES, Holmgren A. Physiological functions of thioredoxin and thioredoxin reductase. Eur J Biochem 2000;267(20):6102-9.
Söderberg A, Sahaf B, Rosén A. Thioredoxine reductase, a redoxactive selenoprotein, is secreted by normal and neoplastic cells: presence in human plasma. Cancer Res 2000;60(8):2281-9.
Miwa K, Kishimoto C, Nakamura H, Makita T, Ishii K, Okuda N, et al. Serum thioredoxin and ?-tocopherol concentrations in patients with major risk factors. Circ J 2005;69(3):291-4.
Kishimoto C, Shioji K, Nakamura H, Nakayama Y, Yodoi J, Sasayama S. Serum thioredoxin (TRX) levels in patients with heart failure. Jpn Circ J 2001;65(6):491-4.
Mallamaci F, Zoccali C, Tripepi G, Benedetto FA, Parlongo S, Cataliotti A, et al. CREED Investigators. The Cardiovascular Risk Extended Evaluation. Diagnostic potential of cardiac natriuretic peptides in dialysis patients. Kidney Int 2001;59(4):1559-66.
McCullough PA, Sandberg KR. B-type natriuretic peptide and renal disease. Heart Fail Rev 2003;8(4):355- 8.
Chazot C, Vo-Van C, Zaoui E, Jean G. Fluid overload correction and cardiac history influence brain natriuretic peptide evolution in incident hemodialysis patients. Nephrol Dial Transplant 2011;26(8):2630-4.
Yılmaz FM, Akay H, Duranay M, Yılmaz G, Öztekin PS, Koşar U, et al. Carotidatherosclerosis and cardiovascular risk factors in hemodialysis and peritoneal dialysis patients. Clin Biochem 2007;40(18):1361-6.
Tonbul HZ, Demir M, Altıntepe L, Güney İ, Yeter E, Türk S, et al. Malnutrition-inflammation-atherosclerosis (MIA) syndrome components in hemodialysis and peritoneal dialysis patients. Ren Fail 2006;28(4):287-94.
Jacobs LH, van de Kerkhof JJ, Mingels AM, Passos VM, Kleijnen VW, Mazairac AH, et al. Inflammation, overhydration and cardiac biomarkers in haemodialysis patients: a longitudinal study. Nephrol Dial Transplant 2010;25(1):243-8.
Booth J, Pinney J, Davenport A. N-terminal proBNP- marker of cardiac dysfunction, fluid overload, or malnutrition in hemodialysis patients? Clin J Am Soc Nephrol. 2010;5(6):1036-40.
Chazot C, Jean G, Vo-Van C, Collonge C, Terrat JC, Vanel T,et al. The plasma level of brain natriuretic peptide is increased in malnourished hemodialysis patients. Blood Purif 2009;28(3):187-92.
Stenvinkel P, Heimbürger O, Lindholm B, Kaysen GA, Bergström J. Are there two types of malnutrition in chronic renal failure? Evidence for relationships between malnutrition, inflammation and atherosclerosis (MIA syndrome). Nephrol Dial Transplant 2000;15(7):953-60.
Davenport A, Willicombe MK: Hydration status does not influence peritoneal equilibration test ultrafiltration volumes. Clin J Am Soc Nephrol 2009;4(7):1207-12.
Paniagua R, Ventura MD, Avila-Diaz M, Hinojosa- Heredia H, Mendez-Duran A, Cueto-Manzano A, et al. NT-proBNP, fluid volume overload and dialysis modality are independent predictors of mortality in ESRD patients. Nephrol Dial Transplant 2010;25(2):551-7.
Gangji AS, Brimble KS, Margetts PJ. Association between markers of inflammation, fibrosis and hypervolaemia in peritoneal dialysis patients. Blood Purif 2009;28(4):354-8.
Paniagua R, Amato D, Mujais S, Vonesh E, Ramos A, Correa-Rotter R, et al. Predictive value of brain natriuretic peptides in patients on peritoneal dialysis: results from the ADEMEX trial. Clin J Am Soc Nephrol 2008;3(2):407-15.
Lemarechal H, Allanore Y, Chenevier-Gobeaux C, Ekindjian OG, Kahan A, Borderie D. High redox thioredoxin but low thioredoxin reductase activities in the serum of patients with rheumatoid arthritis. Clin Chim Acta 2006;367(1-2):156-61.