Ward Richard A, Ouseph Rosemary, McLeish Kenneth R
Department of Medicine University of Louisville and Veterans' Affairs Medical Center, Louisville, Kentucky 40202-1718, USA.
Kidney Int. 2003 Jan;63(1):353-9. doi: 10.1046/j.1523-1755.2003.00741.x.
Neutrophil oxygen radical production is increased in end-stage renal disease (ESRD) patients and it is further enhanced during dialysis with low-flux cellulosic membranes. This increased oxygen radical production may contribute to the protein and lipid oxidation observed in ESRD patients. We tested the hypothesis that high-flux hemodialysis does not increase oxygen radical production and that it is not associated with protein oxidation.
Neutrophil oxygen radical production was measured during dialysis with high-flux dialyzers containing polysulfone and cellulose triacetate membranes. Free sulfhydryl and carbonyl groups and advanced oxidation protein products were measured to assess plasma protein oxidation.
Pre-dialysis, neutrophil oxygen radical production was significantly greater than normal and increased significantly as blood passed through the dialyzer in the first 30 minutes of dialysis. Post-dialysis, however, neutrophil oxygen radical production had decreased and was not different from normal. Pre-dialysis, significant plasma protein oxidation was evident from reduced free sulfhydryl groups, increased carbonyl groups, and increased advanced oxidation protein products. Post-dialysis, plasma protein free sulfhydryl groups had increased to normal levels, while plasma protein carbonyl groups increased slightly, and advanced oxidation protein products remained unchanged.
The results of this study show that neutrophil oxygen radical production normalizes during high-flux dialysis, despite a transient increase early in dialysis. This decrease in oxygen radical production is associated with an improvement in some, but not all, measures of protein oxidation.
终末期肾病（ESRD）患者中性粒细胞氧自由基生成增加，且在使用低通量纤维素膜透析期间进一步增强。这种增加的氧自由基生成可能导致ESRD患者出现蛋白质和脂质氧化。我们检验了以下假设：高通量血液透析不会增加氧自由基生成，且与蛋白质氧化无关。
在使用含聚砜和三醋酸纤维素膜的高通量透析器透析期间，测量中性粒细胞氧自由基生成。测量游离巯基和羰基以及晚期氧化蛋白产物，以评估血浆蛋白氧化。
透析前，中性粒细胞氧自由基生成显著高于正常水平，且在透析的前30分钟血液通过透析器时显著增加。然而，透析后，中性粒细胞氧自由基生成减少，且与正常水平无差异。透析前，游离巯基减少、羰基增加以及晚期氧化蛋白产物增加表明血浆蛋白有明显氧化。透析后，血浆蛋白游离巯基增加至正常水平，而血浆蛋白羰基略有增加，晚期氧化蛋白产物保持不变。
本研究结果表明，尽管透析早期有短暂增加，但在高通量透析期间中性粒细胞氧自由基生成恢复正常。这种氧自由基生成的减少与部分（而非全部）蛋白质氧化指标改善有关。
