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Endothelial dysfunction associated with oxidative stress in human
1Department of Internal Medicine III and the Cardiovascular Research Institute, Kurume University School of Medicine, 67 Asahi-machi, Kurume, 830-0011, Fukuoka, Japan. matsuoka@med.kurumr-u.ac.jp
Diabetes Research and Clinical Practice
|December 6, 2001
Summary
Blood purification therapies impact endothelial function. LDL-apheresis improved it by reducing oxidized LDL, while hemodialysis worsened it due to increased oxidative stress, but vitamin E therapy helped.
Area of Science:
- Cardiovascular Medicine
- Nephrology
- Oxidative Stress Research
Background:
- Endothelial dysfunction, caused by pro- and anti-oxidant imbalance, precedes and worsens atherosclerosis.
- LDL-apheresis benefits hypercholesterolemic patients, while hemodialysis accelerates atherosclerosis in end-stage renal disease patients.
- The impact of blood purification on oxidative modification and endothelial function requires investigation.
Purpose of the Study:
- To investigate the association between oxidative modification and endothelial function during LDL-apheresis and hemodialysis.
- To examine the effect of a single LDL-apheresis session on endothelial function in hypercholesterolemia.
- To assess the effect of a single hemodialysis session on endothelial function in end-stage renal disease.
Main Methods:
- Forearm blood flow (FBF) measured via strain gauge plethysmography before/after LDL-apheresis with acetylcholine (ACh) and sodium nitroprusside (SNP) infusion.
- Flow-mediated dilation (FMD) estimated via ultrasonography before/after hemodialysis.
- Endothelium-independent vasodilation assessed with glyceryltrinitrate (GTN); oxidative modification assessed via oxidized LDL levels; vitamin E-coated dialyzers tested.
Main Results:
- LDL-apheresis reduced oxidized LDL and augmented ACh-induced FBF increase, correlating with reduced oxidized LDL.
- Hemodialysis increased oxidized LDL and impaired endothelium-dependent vasodilation, without affecting GTN response.
- Vitamin E-coated dialyzers during hemodialysis restored endothelium-dependent vasodilation and decreased oxidized LDL.
Conclusions:
- Endothelial function is impaired by acute oxidative stress increase during hemodialysis.
- Antioxidant therapy, like vitamin E-coated dialyzers, can restore endothelial function.
- Controlling oxidative stress is crucial for preserving endothelial function alongside traditional risk factors.