Chan Christopher T, Li Shu Hong, Verma Subodh
Toronto General Hosptal, 200 Elizabeth St., 8N-842, Toronto, Ontario, Canada.
Am J Physiol Renal Physiol. 2005 Oct;289(4):F679-84. doi: 10.1152/ajprenal.00127.2005. Epub 2005 May 31.
Cardiovascular disease is the principal cause of death in end-stage renal disease (ESRD) patients. Endothelial progenitor cells (EPCs) play a critical role in vascular repair, and improving EPC biology represents a novel therapeutic target. Three groups of age- and gender-matched patients were studied: 1) 10 healthy control, 2) 12 conventional hemodialysis (CHD) patients, and 3) 10 nocturnal hemodialysis (NHD) patients. EPC number and migratory function were assessed. Left ventricular mass index (LVMI) was derived, and correlations between EPC biology, uremic clearance, and LVMI were made. Compared with controls, EPC number and function were markedly impaired in CHD patients [(3.48 +/- 1.2 vs. 0.86 +/- 0.20%/50,000 cells, P < 0.05) and (18.8 +/- 2.64 vs. 3.75 +/- 0.34 cells/high-power field, P < 0.05), respectively]. In contrast, EPC number and function were normal in NHD patients [(3.48 +/- 1.17 vs. 3.83 +/- 0.77%/50,000 cells) and (18.8 +/- 2.6 vs. 22.2 +/- 2.4 cells/high-power field), respectively]. Among ESRD patients, EPC number and function inversely correlated with predialysis urea concentration (r = -0.40; r = -0.57), LVMI (r = -0.41; -0.46) and systolic BP (r = -0.58; r = -0.44). We demonstrate that NHD is associated with restoration of abnormal EPC biology in ESRD. Given the increasing importance of EPCs in the repair and restoration of cardiovascular function, these data have important clinical implications for vascular risk in ESRD patients.
心血管疾病是终末期肾病（ESRD）患者的主要死因。内皮祖细胞（EPCs）在血管修复中起关键作用，改善EPC生物学特性是一个新的治疗靶点。研究了三组年龄和性别匹配的患者：1）10名健康对照者，2）12名常规血液透析（CHD）患者，3）10名夜间血液透析（NHD）患者。评估了EPC数量和迁移功能。计算左心室质量指数（LVMI），并分析EPC生物学特性、尿毒症清除率和LVMI之间的相关性。与对照组相比，CHD患者的EPC数量和功能明显受损[分别为（3.48±1.2对0.86±0.20%/50,000细胞，P<0.05）和（18.8±2.64对3.75±0.34细胞/高倍视野，P<0.05）]。相比之下，NHD患者的EPC数量和功能正常[分别为（3.48±1.17对3.83±0.77%/50,000细胞）和（18.8±2.6对22.2±2.4细胞/高倍视野）]。在ESRD患者中，EPC数量和功能与透析前尿素浓度（r=-0.40；r=-0.57）、LVMI（r=-0.41；-0.46）和收缩压（r=-0.58；r=-0.44）呈负相关。我们证明，NHD与ESRD患者异常EPC生物学特性的恢复有关。鉴于EPCs在心血管功能修复和恢复中的重要性日益增加，这些数据对ESRD患者的血管风险具有重要的临床意义。
