Alhamdani M S, Al-Najjar A F, Al-Kassir A H
Department of Clinical Biochemistry, College of Pharmacy, Al-Mustansiriya University, Baghdad, Iraq.
Int J Artif Organs. 2005 Jun;28(6):576-82. doi: 10.1177/039139880502800606.
Uremic patients, especially those receiving regular hemodialysis (HD) treatment, are at high risk of oxidative damage by noxious free radicals and reactive oxygen species (ROS). The erythrocyte glutathione-defense system (GSH-DS) is one of the major enzymatic means of scavenging and detoxifying ROS. This study aimed to elucidate the effect of HD and dialyzer biocompatibility on erythrocyte GSH-DS in uremic patients on maintenance HD treatment.
Twenty-five healthy volunteers and 42 HD patients were enrolled in this study. Blood samples were drawn immediately before and after HD session, and erythrocyte glutathione (GSH) level as well as the activities of the enzymes glucose-6-phosphate dehydrogenase (G6PD), glutathione peroxidase (GSH-Px), glutathione reductase (GSSG-Rd), and glutathione S-transferase (GST) were measured. To evaluate the effect of dialyzer type on the studied parameters the patients were were subdivided into two groups: those who had dialysis with cuprophane (CU) membranes (n=23) and those who received dialysis with the aid of polysulfone (PS) membranes (n=19).
The activities of G6PD and GSH-Px as well as GSH level were significantly decreased in HD patients as compared with controls. On the other hand, the activities of GSSG-Rd and GST were significantly elevated among HD patients in comparison with control values. A single HD session, regardless of the type of dialyzer, did not induce any significant effect on any of the measured parameters, although G6PD activity increased significantly after dialysis. CU membrane did not result in any change in GSH or its metabolizing enzymes, while PS dialyzers exerted a minor but significant restoration in GSH-DS.
The antioxidant pool, as represented by GSH-DS, is significantly affected by dialyzer type in HD patients being significantly corrected with polysulfone dialyzer.
尿毒症患者，尤其是接受定期血液透析（HD）治疗的患者，极易受到有害自由基和活性氧（ROS）的氧化损伤。红细胞谷胱甘肽防御系统（GSH-DS）是清除和解毒ROS的主要酶促方式之一。本研究旨在阐明HD及透析器生物相容性对维持性HD治疗的尿毒症患者红细胞GSH-DS的影响。
本研究纳入了25名健康志愿者和42名HD患者。在HD治疗前后即刻采集血样，检测红细胞谷胱甘肽（GSH）水平以及葡萄糖-6-磷酸脱氢酶（G6PD）、谷胱甘肽过氧化物酶（GSH-Px）、谷胱甘肽还原酶（GSSG-Rd）和谷胱甘肽S-转移酶（GST）的活性。为评估透析器类型对研究参数的影响，将患者分为两组：使用铜仿膜（CU）进行透析的患者（n = 23）和使用聚砜膜（PS）进行透析的患者（n = 19）。
与对照组相比，HD患者的G6PD和GSH-Px活性以及GSH水平显著降低。另一方面，与对照值相比，HD患者的GSSG-Rd和GST活性显著升高。尽管透析后G6PD活性显著增加，但无论透析器类型如何，单次HD治疗均未对任何测量参数产生显著影响。CU膜对GSH或其代谢酶没有任何影响，而PS透析器对GSH-DS有轻微但显著的恢复作用。
以GSH-DS为代表的抗氧化池在HD患者中受透析器类型的显著影响，聚砜透析器可使其得到显著改善。
