Musiał Kinga, Szprynger Krystyna, Szczepańska Maria, Zwolińska Danuta
Department of Pediatric Nephrology, Wrocław Medical University, 50-369 Wrocław, Poland.
Pediatr Nephrol. 2009 Oct;24(10):2029-34. doi: 10.1007/s00467-009-1197-7. Epub 2009 May 28.
Chronic inflammation, lipid and autoimmune disorders are hallmarks of atherogenesis, and hemodialysis per se may be an additional factor predisposing to accelerated atherosclerosis. Elevated levels of heat shock proteins (HSP) and antibodies against these HSP have been described in adults with atherosclerotic lesions and cardiovascular events, but to date there has been a scarcity of investigations on these parameters in adult and pediatric patients on hemodialysis (HD). We have investigated the HSP profile in hemodialyzed children and the impact of a single HD session on those proteins and their correlations with known risk factors for atherosclerosis. The study group consisted of 17 children and young adults undergoing HD with polysulfone membranes. The control group comprised 15 age-matched subjects with normal kidney function. The serum concentrations of Hsp60, Hsp90alpha, anti-Hsp60, anti-Hsp70, and sE-selectin were assessed by an enzyme-linked immunosorbent assay, and serum concentration of high-sensitivity-C-reactive protein was assayed by nephelometry. The serum lipid profile [total cholesterol (CHOL), high-density lipoprotein-CHOL, low-density lipoprotein-CHOL, triglycerides] was also estimated. Compared to the control values, the median values of Hsp60 before the HD session were lower, whereas those of Hsp90alpha and anti-Hsp60 were higher. A single HD session raised the median values of Hsp60 and Hsp90alpha and decreased the concentrations of anti-Hsp60 and anti-Hsp70. In addition, the concentrations of HSPs and the antibodies against them correlated with the lipid markers both before and after HD. The altered HSP and anti-HSP concentrations in HD children, which correlated with the lipid profile and the endothelial markers, suggest a dysfunctional HSP system in this population and the possibility of HSPs being classified as new markers of atherosclerosis.
慢性炎症、脂质紊乱和自身免疫性疾病是动脉粥样硬化形成的标志，而血液透析本身可能是加速动脉粥样硬化的一个额外因素。在患有动脉粥样硬化病变和心血管事件的成年人中，已发现热休克蛋白（HSP）水平升高以及针对这些HSP的抗体，但迄今为止，对接受血液透析（HD）的成人和儿童患者的这些参数的研究较少。我们研究了接受血液透析儿童的HSP谱，以及单次HD治疗对这些蛋白质的影响及其与动脉粥样硬化已知危险因素的相关性。研究组由17名接受聚砜膜血液透析的儿童和年轻成年人组成。对照组包括15名年龄匹配、肾功能正常的受试者。通过酶联免疫吸附测定法评估Hsp60、Hsp90α、抗Hsp60、抗Hsp70和可溶性E选择素的血清浓度，通过散射比浊法测定高敏C反应蛋白的血清浓度。还评估了血清脂质谱[总胆固醇（CHOL）、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、甘油三酯]。与对照值相比，HD治疗前Hsp60的中位数较低，而Hsp90α和抗Hsp60的中位数较高。单次HD治疗使Hsp60和Hsp90α的中位数升高，并降低了抗Hsp60和抗Hsp70的浓度。此外，HD前后HSP及其抗体的浓度均与脂质标志物相关。HD儿童中HSP和抗HSP浓度的改变与脂质谱和内皮标志物相关，提示该人群中HSP系统功能失调，并且HSP有可能被归类为动脉粥样硬化的新标志物。
