Minz M, Heer M, Arora S, Sharma A, Khullar M
Department of Transplant Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Transplant Proc. 2006 Sep;38(7):2020-1. doi: 10.1016/j.transproceed.2006.07.005.
Increased oxidative stress and hyperhomocysteinemia are frequently observed in patients with end-stage renal disease. The effects of kidney transplantation on oxidative state are incompletely understood. With an aim to evaluate the prevalence and severity of oxidative stress in living donor renal transplant recipients, we conducted a cross-sectional study. Thirty-five renal transplant recipients (mean age 34 years; body mass index 21.93 +/- 1.92) with normal renal function (mean serum creatinine 1.41 +/- 0.33 mg%) were enrolled in the study. All patients were on cyclosporine-based immunosuppression. We assessed serum nitric oxide (NO) levels, plasma total homocysteine levels (tHCy), and malonaldehyde (MDA) levels. We evaluated the antioxidant power ferric reducing ability of plasma (FRAP) assay. The mean duration to the first sampling was 9.23 months after transplantation. Fourteen age- and sex-matched normotensive people were used as controls. The mean tHCy was significantly higher among patients (15.29 +/- 0.66 mmol/L compared with controls (9.58 +/- 2.90 mmol/L; P < .05). The MDA levels in patients (6.405 +/- 2.05 nmol/mL) were comparable to controls (6.093 +/- 1.93 nmol/mL; P = .099). The status of antioxidative power as measured by FRAP showed a trend to higher antioxidative status (697.57 +/- 103.07 mmol/L) in patients compared with controls (518 +/- 120.99 mmol/L; P = NS). The mean NO levels in patients (545.01 +/- 281.49 mmol/mL) were significantly higher than controls (183.49 +/- 64.53 nmol/mL; P < .05). Stable renal transplant recipients display a pattern of increased oxidant stress that may be counterbalanced by an enhanced antioxidant mechanisms.
终末期肾病患者常出现氧化应激增加和高同型半胱氨酸血症。肾移植对氧化状态的影响尚未完全明确。为评估活体供肾肾移植受者氧化应激的发生率和严重程度，我们进行了一项横断面研究。35例肾功能正常（平均血清肌酐1.41±0.33mg%）的肾移植受者（平均年龄34岁；体重指数21.93±1.92）纳入本研究。所有患者均接受以环孢素为基础的免疫抑制治疗。我们评估了血清一氧化氮（NO）水平、血浆总同型半胱氨酸水平（tHCy）和丙二醛（MDA）水平。我们采用血浆铁还原能力（FRAP）测定法评估抗氧化能力。首次采样的平均时间为移植后9.23个月。选取14例年龄和性别匹配的血压正常者作为对照。患者的平均tHCy显著高于对照组（15.29±0.66mmol/L，对照组为9.58±2.90mmol/L；P<0.05）。患者的MDA水平（6.405±2.05nmol/mL）与对照组（6.093±1.93nmol/mL；P=0.099）相当。通过FRAP测定的抗氧化能力状态显示，患者的抗氧化状态有高于对照组的趋势（697.57±103.07mmol/L，对照组为518±120.99mmol/L；P=无显著性差异）。患者的平均NO水平（545.01±281.49mmol/mL）显著高于对照组（183.49±64.53nmol/mL；P<0.05）。稳定的肾移植受者表现出氧化应激增加的模式，这可能被增强的抗氧化机制所抵消。
