Colì Luigi, Donati Gabriele, Cappuccilli Maria L, Cianciolo Giuseppe, Comai Giorgia, Cuna Vania, Carretta Elisa, La Manna Gaetano, Stefoni Sergio
Nephrology, Dialysis and Renal Transplant Unit, S Orsola University Hospital, Bologna, Italy.
Int J Artif Organs. 2011 Jun;34(6):481-8. doi: 10.5301/IJAO.2011.8466.
The aim of this study was to ascertain the role of different vascular access types in inflammatory status, monocyte activation, and senescence in hemodialysis patients.
We recruited 126 hemodialysis patients, including 51 with arterovenous fistula (AVF), 32 with arterovenous graft (AVG), and 43 with tunneled cuffed catheters (TCC). In dialysis patients enrolled in the study and in a control group of 40 healthy subjects, we measured the serum levels of albumin, CRP, IL-6, and TNF-a, the expression of CD14, CD44, and CD32 on monocyte surface, and the percentage of monocytes exhibiting a senescent phenotype (CD14+CD32+).
The patients with AVG compared to those with AVF had: a) higher levels of CRP and TNF-a; b) increased expression of CD14 and CD32 on monocyte surface, with no difference in CD44 expression; c) no difference in the percentage of CD14+CD32+ monocytes. In the comparison of TCC vs. AVF group, we observed significantly higher values of: a) circulating inflammatory markers (CRP, IL-6, TNF-a); b) monocyte surface expression of cellular activation markers (CD14, CD44 and CD32); c) relative count of CD14+CD32+ monocytes. When comparing TCC vs. AVG group, we found: a) no difference in serum levels of CRP, IL-6, and TNF-a; b) no difference in the expression of CD14, CD44, and CD32 on monocyte surface; c) no difference in the percentage of CD14+CD32+ monocytes.
These results suggest that the use of AVG and TCC for dialysis vascular access is associated with serological and cellular indexes of inflammatory reaction, also resulting in a higher degree of monocyte activation and senescence.
本研究旨在确定不同血管通路类型在血液透析患者炎症状态、单核细胞活化和衰老中的作用。
我们招募了126名血液透析患者，其中51名使用动静脉内瘘（AVF），32名使用动静脉移植物（AVG），43名使用带隧道带涤纶套导管（TCC）。在纳入研究的透析患者和40名健康受试者的对照组中，我们测量了血清白蛋白、CRP、IL-6和TNF-a水平、单核细胞表面CD14、CD44和CD32的表达，以及表现出衰老表型（CD14+CD32+）的单核细胞百分比。
与AVF患者相比，AVG患者有：a）CRP和TNF-a水平更高；b）单核细胞表面CD14和CD32表达增加，CD44表达无差异；c）CD14+CD32+单核细胞百分比无差异。在TCC与AVF组的比较中，我们观察到以下显著更高的值：a）循环炎症标志物（CRP、IL-6、TNF-a）；b）细胞活化标志物（CD14、CD44和CD32）的单核细胞表面表达；c）CD14+CD32+单核细胞的相对计数。在比较TCC与AVG组时，我们发现：a）CRP、IL-6和TNF-a的血清水平无差异；b）单核细胞表面CD14、CD44和CD32的表达无差异；c）CD14+CD32+单核细胞百分比无差异。
这些结果表明，使用AVG和TCC作为透析血管通路与炎症反应的血清学和细胞指标相关，也导致更高程度的单核细胞活化和衰老。
