Bonnefont-Rousselot D, Lehmann E, Jaudon M C, Delattre J, Perrone B, Rechke J P
Laboratoire de Biochimie, Hôpital de la Salpêtrière, Assistance Publique-Hôpitaux de Paris, Paris, France.
Nephrol Dial Transplant. 2000 Dec;15(12):2020-8. doi: 10.1093/ndt/15.12.2020.
Oxidative stress has been shown in haemodialysis patients in relation with an increased production of free radicals due to membrane-induced complement and leukocyte activation. In order to minimize membrane bioincompatibility and thereby oxidative stress, more compatible filters have been perfected. Among them, a high-flux vitamin E-coated membrane (CL-EE) has been proposed recently. In vivo, little data is available on the consequences of the use of vitamin E-coated membranes. In the present study, the effects of a 3-month use of CL-EE dialysis membranes compared to conventional membranes have been evaluated in 12 haemodialysis patients on the blood oxidative stress status before and after the dialysis session.
We determined the lipid peroxidation status (plasma thiobarbituric acid-reactive substances) and antioxidant defence (erythrocyte Cu,Zn-superoxide dismutase and plasma and erythrocyte glutathione peroxidase activities, plasma vitamin E, beta-carotene, vitamin A and total antioxidant status). Also, we simultaneously determined the antioxidant content and the copper oxidizability of isolated low density- and high density-lipoproteins (LDLs and HDLs).
The main consequence observed under these conditions was a marked enrichment of plasma with vitamin E, which was also significantly and selectively noted in HDLs (no changes in LDL vitamin E content), perhaps related to a specific storage capacity for vitamin E in HDLs of haemodialysis patients. The beta-carotene content of plasma, LDLs and HDLs was also higher after use of vitamin E-coated membranes than after use of high-flux biocompatible membranes. HDL copper oxidizability was reduced (as shown by an increased lag time) before dialysis after use of CL-EE membranes compared to conventional membranes, whereas LDL oxidizability remained unchanged.
A 3-month use of vitamin E-coated membranes resulted in a significant increase in plasma and HDL vitamin E content, associated with a lower oxidizability of HDLs, which could be beneficial for haemodialysis patients.
血液透析患者体内存在氧化应激，这与因膜诱导补体和白细胞激活导致的自由基生成增加有关。为了将膜生物不相容性降至最低，从而减轻氧化应激，人们研发出了更具相容性的滤器。其中，一种高通量维生素E涂层膜（CL-EE）最近被提出。在体内，关于使用维生素E涂层膜的后果的数据很少。在本研究中，我们评估了12例血液透析患者使用CL-EE透析膜3个月与使用传统膜相比，对透析前后血液氧化应激状态的影响。
我们测定了脂质过氧化状态（血浆硫代巴比妥酸反应性物质）和抗氧化防御能力（红细胞铜锌超氧化物歧化酶以及血浆和红细胞谷胱甘肽过氧化物酶活性、血浆维生素E、β-胡萝卜素、维生素A和总抗氧化状态）。此外，我们还同时测定了分离出的低密度脂蛋白和高密度脂蛋白（LDL和HDL）的抗氧化成分和铜氧化能力。
在这些条件下观察到的主要结果是血浆中维生素E显著富集，在HDL中也有显著且选择性的富集（LDL中维生素E含量无变化），这可能与血液透析患者HDL中维生素E的特定储存能力有关。使用维生素E涂层膜后，血浆、LDL和HDL中的β-胡萝卜素含量也高于使用高通量生物相容性膜后。与传统膜相比，使用CL-EE膜透析前HDL的铜氧化能力降低（表现为延迟时间增加），而LDL的氧化能力保持不变。
使用维生素E涂层膜3个月导致血浆和HDL中维生素E含量显著增加，同时HDL的氧化能力降低，这可能对血液透析患者有益。
