Lucchi L, Bergamini S, Botti B, Rapanà R, Ciuffreda A, Ruggiero P, Ballestri M, Tomasi A, Albertazzi A
Department of Internal Medicine, University Hospital, Modena, Italy.
Artif Organs. 2000 Jan;24(1):1-6. doi: 10.1046/j.1525-1594.2000.06432.x.
Oxidative stress is crucial in red blood cell (RBC) damage induced by activated neutrophils in in vitro experiments. The aim of the study was to evaluate whether the bioincompatibility phenomena occurring during hemodialysis (HD) (where neutrophil activation with increased free radical production is well documented) may have detrimental effects on RBC. We evaluated RBC susceptibility to oxidative stress before and after HD in 15 patients using Cuprophan, cellulose triacetate, and polysulfone membrane. RBC were incubated with t-butyl hydroperoxide as an oxidizing agent both in the presence and in the absence of the catalase inhibitor sodium azide. The level of malonaldehyde (MDA), a product of lipid peroxidation, was measured at 0, 5, 10, 15, and 30 min of incubation. When Cuprophan membrane was used, the MDA production was significantly higher after HD, indicating an increased susceptibility to oxidative stress in comparison to pre-HD. The addition of sodium azide enhanced this phenomenon. Both cellulose triacetate and polysulfone membranes did not significantly influence RBC susceptibility to oxidative stress. Neither the level of RBC reduced glutathione nor the RBC glutathione redox ratio changed significantly during HD with any of the membranes used. The RBC susceptibility to oxidative stress was influenced in different ways according to the dialysis membrane used, being increased only when using the more bioincompatible membrane Cuprophan, where neutrophil activation with increased free radical production is well documented. The alterations found in this study might contribute to the reduced RBC longevity of HD patients where a bioincompatible membrane is used.
在体外实验中，氧化应激在活化中性粒细胞诱导的红细胞（RBC）损伤中起关键作用。本研究的目的是评估血液透析（HD）过程中发生的生物不相容现象（大量文献记载HD过程中中性粒细胞活化并伴有自由基生成增加）是否可能对红细胞产生有害影响。我们使用铜仿膜、三醋酸纤维素膜和聚砜膜，对15例患者血液透析前后红细胞对氧化应激的敏感性进行了评估。红细胞在有和没有过氧化氢酶抑制剂叠氮化钠存在的情况下，均与作为氧化剂的叔丁基过氧化氢一起孵育。在孵育0、5、10、15和30分钟时，测量脂质过氧化产物丙二醛（MDA）的水平。当使用铜仿膜时，血液透析后MDA生成显著更高，表明与透析前相比，红细胞对氧化应激的敏感性增加。添加叠氮化钠增强了这一现象。三醋酸纤维素膜和聚砜膜均未显著影响红细胞对氧化应激的敏感性。使用任何一种膜进行血液透析期间，红细胞还原型谷胱甘肽水平和红细胞谷胱甘肽氧化还原比均未发生显著变化。根据所使用的透析膜不同，红细胞对氧化应激的敏感性受到不同方式的影响，仅在使用生物不相容性更强的铜仿膜时增加，大量文献记载该膜会导致中性粒细胞活化并伴有自由基生成增加。本研究中发现的这些改变可能导致使用生物不相容膜的血液透析患者红细胞寿命缩短。
