Document Detail


Lymphocyte 5'-nucleotidase and aminopeptidase N activity in patients on maintenance hemodialysis treated with human recombinant erythropoietin and 1-alpha-D3.
MedLine Citation:
PMID:  15957544     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Patients with end-stage renal disease (ESKD) present an immunodeficiency state paradoxically exacerbated by hemodialysis (HD) and associated with signs of T-cell activation. B cells are also activated in uremia, and this activation could be altered by erythropoietin therapy in HD patients. In this study, the effects of human recombinant erythropoietin (rHu-EPO) and 1-alpha-D3 treatments on lymphocyte immunomodulatory enzymes, aminopeptidase N (APN), and 5'-nucleotidase activity in patients on HD were investigated in hemodialysis patients before and after two-month treatment with s.c. rHu-EPO (15 patients, 2000-3000 U three times weekly) or oral 1-alpha-D3 (14 patients, 2 microg three times weekly). RESULTS: A two-month EPO treatment of 15 HD patients produced a rise in hemoglobin from 6.51 +/- 0.18 to 9.69 +/- 0.14 g/dL. Basal lymphocyte APN activity in HD patients was not significantly different from the level in healthy controls. Treatment of patients with rHu-EPO increased unstimulated lymphocyte APN activity to values significantly higher than those before treatment (p<0.05). A two-month pulse oral 1-alpha-D3 treatment of 14 HD patients increased hematocrit by 21% and raised hemoglobin from 7.11 +/- 0.32 to 8.80 +/- 0.39 g/dL. Unstimulated and Con A-stimulated lymphocyte APN activity after pulse oral 1-alpha-D3 was significantly increased (p<0.01 and p<0.05, respectively) from the pretreatment levels. In HD patients lymphocyte basal, Con A-, and PMA-stimulated 5'-nucleotidase activity was significantly higher (p<0.05) than it was in healthy controls. The two-month treatment with rHu-EPO or pulse oral 1-alpha D3 did not change the level of lymphocyte 5'-nucleotidase in these patients. CONCLUSIONS: This study demonstrated that a two-month treatment of HD patients with rHu-EPO or pulse oral 1-alpha D3 significantly increases activity of lymphocyte APN, important for cleavage of peptides and small proteins, which accumulate in the blood of ESKD patients. In HD patients lymphocyte ecto-5'-nucleotidase activity was significantly higher than that in healthy controls and was not changed after a two-month treatment with rHu-EPO or pulse oral 1-alpha D3. We speculate that oxidative stress activates 5'-nucleotidase and production of adenosine by lymphocytes of HD patients.
Authors:
Vladisav Stefanovic; Marina Mitić-Zlatkovic; Jasmina Radivojevic; Predrag Vlahovic
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Renal failure     Volume:  27     ISSN:  0886-022X     ISO Abbreviation:  Ren Fail     Publication Date:  2005  
Date Detail:
Created Date:  2005-06-16     Completed Date:  2005-09-22     Revised Date:  2008-05-21    
Medline Journal Info:
Nlm Unique ID:  8701128     Medline TA:  Ren Fail     Country:  United States    
Other Details:
Languages:  eng     Pagination:  283-8     Citation Subset:  IM    
Affiliation:
Institute of Nephrology and Hemodialysis, Faculty of Medicine, Nis, Serbia. stefan@ni.ac.yu
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MeSH Terms
Descriptor/Qualifier:
5'-Nucleotidase / metabolism*
Administration, Oral
Adult
Aged
Anemia / blood,  drug therapy*,  etiology
Antigens, CD13 / metabolism*
Biological Markers / metabolism
Cells, Cultured
Drug Therapy, Combination
Erythropoietin, Recombinant / administration & dosage,  therapeutic use*
Female
Follow-Up Studies
Hemoglobins / metabolism
Humans
Kidney Failure, Chronic / blood*,  complications,  therapy
Lymphocytes / cytology,  enzymology*
Male
Middle Aged
Treatment Outcome
Vitamin D / administration & dosage,  analogs & derivatives*,  therapeutic use
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Erythropoietin, Recombinant; 0/Hemoglobins; 1406-16-2/Vitamin D; 78609-64-0/1-alpha, 25-difluorovitamin D3; EC 3.1.3.5/5'-Nucleotidase; EC 3.4.11.2/Antigens, CD13

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