Handelman G J, Walter M F, Adhikarla R, Gross J, Dallal G E, Levin N W, Blumberg J B
Antioxidants Research Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts, USA.
Kidney Int. 2001 May;59(5):1960-6. doi: 10.1046/j.1523-1755.2001.0590051960.x.
End-stage renal disease (ESRD) patients on long-term hemodialysis (HD) may be under increased oxidative stress, caused by either HD or renal failure. Plasma F2-isoprostanes have been established as an important indicator of in vivo oxidative stress.
Plasma esterified F2-isoprostanes were measured in 25 HD patients and 23 controls with normal renal function, employing gas chromatography-mass spectrometry with negative chemical ionization (GC-MS-NCI). C-reactive protein (CRP) was determined concurrently in patients and controls by enzyme-linked immunosorbent assay (ELISA). alpha-Tocopherol, retinol, albumin and creatinine were also determined.
The average total esterified F2-isoprostanes in the ESRD patients was 1.62 +/- 0.73 vs. 0.27 +/- 0.10 ng/mL in controls (P < 0.001), with no overlap between patients and controls. Plasma F2-isoprostanes in diabetic ESRD patients were similar to F2-isoprostanes in patients with other causes for renal failure. In a subset of 10 of these ESRD patients evaluated eight months after the initial measurement, plasma-esterified F2-isoprostanes were not altered by an individual dialysis session. Average plasma CRP values were also higher in HD patients (P < 0.02), but some patients had CRP values that were similar to controls. In the HD patients, total plasma F2-isoprostanes and plasma CRP were correlated (r = 0.48, P = 0.015). Plasma alpha-tocopherol did not differ between patients and controls, but plasma retinol was higher in patients (3.15 +/- 1.71 micromol/L) than in controls (1.97 +/- 0.51 micromol/L, P < 0.05).
These results are consistent with the hypothesis that oxidative stress in ESRD patients contributes to increased values of esterified plasma F2-isoprostanes, with concurrent increases in plasma CRP levels in some patients. Impaired clearance of esterified F2-isoprostanes may contribute to the elevated levels in renal failure. Plasma esterified F2-isoprostanes may be a useful indicator to evaluate effectiveness of interventions to decrease oxidative stress and associated inflammation.
长期接受血液透析（HD）的终末期肾病（ESRD）患者可能处于氧化应激增加的状态，这是由血液透析或肾衰竭引起的。血浆F2 - 异前列腺素已被确立为体内氧化应激的重要指标。
采用带负化学电离的气相色谱 - 质谱联用仪（GC - MS - NCI）测定25例血液透析患者和23例肾功能正常的对照者血浆中酯化F2 - 异前列腺素的含量。同时采用酶联免疫吸附测定法（ELISA）测定患者和对照者的C反应蛋白（CRP）。还测定了α - 生育酚、视黄醇、白蛋白和肌酐。
ESRD患者中总酯化F2 - 异前列腺素的平均含量为1.62±0.73 ng/mL，而对照组为0.27±0.10 ng/mL（P < 0.001），患者和对照者之间无重叠。糖尿病ESRD患者的血浆F2 - 异前列腺素与其他肾衰竭病因患者的相似。在这些ESRD患者中，对其中10例在初次测量8个月后进行评估，单次透析治疗并未改变血浆酯化F2 - 异前列腺素水平。血液透析患者的血浆CRP平均水平也较高（P < 0.02），但部分患者的CRP水平与对照者相似。在血液透析患者中，血浆总F2 - 异前列腺素与血浆CRP相关（r = 0.48，P = 0.015）。患者和对照者之间血浆α - 生育酚无差异，但患者的血浆视黄醇（3.15±1.71 μmol/L）高于对照者（1.97±0.51 μmol/L，P < 0.05）。
这些结果与以下假设一致，即ESRD患者的氧化应激导致血浆酯化F2 - 异前列腺素水平升高，同时部分患者血浆CRP水平也升高。酯化F2 - 异前列腺素清除受损可能导致肾衰竭时其水平升高。血浆酯化F2 - 异前列腺素可能是评估降低氧化应激及相关炎症干预措施有效性的有用指标。
