Friedrich Björn, Alexander Dorothea, Aicher Wilhelm Karl, Duszenko Michael, Schaub Thomas Patrick, Passlick-Deetjen Jutta, Waldegger Siegfried, Wolf Sabine, Risler Teut, Lang Florian
Department of Internal Medicine, University of Tübingen, Germany.
Nephrol Dial Transplant. 2005 Apr;20(4):768-74. doi: 10.1093/ndt/gfh697. Epub 2005 Feb 8.
Standard haemodialysis (HD) rapidly alters osmolality and composition of extracellular fluid and, thus, challenges cell volume constancy. Cell volume-sensitive genes upregulated by osmotic cell shrinkage include those encoding for taurine transporter TAUT as well as for serum- and glucocorticoid-inducible kinase SGK1.
Six HD patients were haemodialysed for 4 h with high-flux dialysers. Blood was drawn from the arterial section of the fistula immediately prior to start of HD and subsequently after 60, 120 and 240 min of HD treatment and, in addition, 120 min after HD treatment. Taurine plasma concentrations ([taurine]p) and erythrocytic taurine content ([taurine]e) were determined by high-performance liquid chromatography. SGK1 and TAUT transcript levels in leukocytes were quantified by real-time polymerase chain reaction.
The [taurine]p was significantly higher in HD patients before HD treatment when compared with healthy controls and it decreased significantly during 4 h of HD. The ratio of SGK1/GAPDH and of TAUT/GAPDH transcript levels increased significantly by 50% or 27%, respectively, during HD.
Standard HD treatment decreases plasma taurine concentration and upregulates leukocyte SGK1 and TAUT transcription. As SGK1 is a potent regulator of ion channels and transporters in nervous system, heart muscle and epithelial cells, the deranged regulation of SGK1 may contribute to acute side effects of HD treatment.
标准血液透析(HD)会迅速改变细胞外液的渗透压和成分,从而对细胞体积的恒定构成挑战。因渗透性细胞皱缩而上调的细胞体积敏感基因包括编码牛磺酸转运体TAUT以及血清和糖皮质激素诱导激酶SGK1的基因。
6名HD患者使用高通量透析器进行4小时血液透析。在HD开始前立即从瘘管的动脉段采血,随后在HD治疗60、120和240分钟后采血,此外,在HD治疗后120分钟采血。通过高效液相色谱法测定血浆牛磺酸浓度([牛磺酸]p)和红细胞牛磺酸含量([牛磺酸]e)。通过实时聚合酶链反应定量白细胞中SGK1和TAUT的转录水平。
与健康对照相比,HD患者在HD治疗前的[牛磺酸]p显著更高,并且在4小时的HD过程中显著降低。在HD期间,SGK1/GAPDH和TAUT/GAPDH转录水平的比率分别显著增加50%或27%。
标准HD治疗会降低血浆牛磺酸浓度,并上调白细胞SGK1和TAUT的转录。由于SGK1是神经系统、心肌和上皮细胞中离子通道和转运体的有效调节剂,SGK1的调节紊乱可能导致HD治疗的急性副作用。