在腹腔透析患者中通过可想象的不同的途径激活全身和局部补充剂
Bernardo Faria1,2,3, Mariana Gaya da Costa1,4, Anita H Meter-Arkema1
1Division of Nephrology, Department of Internal Medicine, University Medical Center Groningen, University of Groningen, The Netherlands.
概括
这项研究表明,腹膜透析 (PD) 患者表现出系统和局部补体激活,这似乎是独立的过程. 了解补充系统的作用对于改善PD结果至关重要.
科学领域:
- 腎病學和免疫學 腎病學和免疫學
- 补充系统生物学 补充系统生物学
- 脏替代疗法治疗 脏替代疗法
背景情况:
- 腹膜透析 (PD) 由于与膜纤维化和腹膜炎相关的高失败率而未得到充分利用.
- 补充系统在PD并发症中的作用需要进一步调查.
- 以前的研究表明,补充激活可能会伤害PD患者.
研究的目的:
- 在接受腹腔透析的患者中研究全身和局部补充激活.
- 为了比较PD患者的补充激活标记与血液透析 (HD) 患者,慢性病 (CKD) 患者和健康对照.
- 探索PD中系统和局部补充激活之间的关系.
主要方法:
- 在PD,HD,CKD和对照组中测量了补充因子 (C1q,MBL,Properdin,D因子,C3d/C3比率,sC5b-9) 的血水平.
- 在腹膜透析液 (PDF) 中评估补充因子 (C1q,MBL,Properdin,D因子,sC5b-9).
- 量化炎症标志物 (IL-6,MMP-2,MPO,弹性酶) 在PDF中来自PD患者的一个小组.
主要成果:
- 与其他组相比,PD患者的可溶性膜攻击复合体 (sC5b-9) 系统水平显著更高 (p < 0.001).
- 系统的sC5b-9水平与血C1q和C3d/C3比率相关 (p < 0.001).
- 在PDF中的局部sC5b-9与PDFproperdin水平 (p < 0.001) 和炎症标志物 (弹性酶,MPO,MMP-2) (p < 0.01) 相相关,但与全身sC5b-9.
结论:
- 腹腔透析患者表现出明显的全身和局部补体激活.
- 这些系统和局部补充激活过程看起来是独立的.
- 对补充途径的进一步研究可能会提供改善PD技术生存的策略.
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