Al-Massarani G, Vacher-Coponat H, Paul P, Arnaud L, Loundou A, Robert S, Moal V, Berland Y, Dignat-George F, Camoin-Jau L
UMR-S 608 INSERM-Université de Méditerranée, Aix-Marseille 2, Laboratoire d'Hématologie et d'Immunologie, UFR de Pharmacie, Marseille, France.
Am J Transplant. 2009 Mar;9(3):550-7. doi: 10.1111/j.1600-6143.2008.02532.x.
Microparticles (MP) are important players in cardiovascular disorders. Renal transplantation significantly improves the survival of hemodialyzed patients, in part because cardiovascular disease (CVD) progression is lessened. We hypothesized that the beneficial effect of renal transplantation on cardiovascular outcome might involve decreased levels of circulating MP. We evaluated the kinetics of MP subpopulations and their procoagulant activity (MP-PCA) in 52 patients before and 3, 6, 9 and 12 months after graft with reference to 50 healthy controls and we evaluated the impact of cardiovascular complications. During the follow-up, the increased levels of MP observed before graft were significantly decreased and reached normal values with different kinetics according to their cellular origin whereas MP-PCA remained significantly higher than in controls. From multivariate analysis, the levels of MP were negatively correlated with renal function. At 12 months, the decrease in MP and MP-PCA was more pronounced in patients without history of CVD than those with. In conclusion, we demonstrated that renal graft is associated with decreased levels of MP levels and MP-PCA, even more pronounced so in patients without history of CVD. Therefore, we suggest that MP lowering could be involved in the vascular dysfunction improvements reported after transplantation.
微粒(MP)是心血管疾病中的重要因素。肾移植显著提高了血液透析患者的生存率,部分原因是心血管疾病(CVD)的进展减缓。我们假设肾移植对心血管结局的有益作用可能与循环MP水平降低有关。我们参照50名健康对照者,评估了52例患者在移植前以及移植后3、6、9和12个月时MP亚群的动力学及其促凝活性(MP-PCA),并评估了心血管并发症的影响。在随访期间,移植前观察到的MP水平升高显著降低,并根据其细胞来源以不同的动力学达到正常水平,而MP-PCA仍显著高于对照组。多因素分析显示,MP水平与肾功能呈负相关。在12个月时,无CVD病史的患者MP和MP-PCA的降低比有CVD病史的患者更明显。总之,我们证明肾移植与MP水平和MP-PCA降低有关,在无CVD病史的患者中更为明显。因此,我们认为MP水平降低可能与移植后报道的血管功能障碍改善有关。