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血小板围手术期抗氧化能力与肾移植后早期功能的关系:一项初步研究。

Association between the perioperative antioxidative ability of platelets and early post-transplant function of kidney allografts: a pilot study.

机构信息

Department of Laboratory Diagnostics and Molecular Medicine, Pomeranian Medical University, Szczecin, Poland.

出版信息

PLoS One. 2012;7(1):e29779. doi: 10.1371/journal.pone.0029779. Epub 2012 Jan 18.

Abstract

BACKGROUND

Recent studies have demonstrated that the actions of platelets may unfavorably influence post-transplant function of organ allografts. In this study, the association between post-transplant graft function and the perioperative activity of platelet antioxidants was examined among kidney recipients divided into early (EGF), slow (SGF), and delayed graft function (DGF) groups.

METHODOLOGY/PRINCIPAL FINDINGS: Activities of superoxide dismutase, catalase, glutathione transferase (GST), glutathione peroxidase, and glucose-6-phosphate dehydrogenase (G6P) were determined and levels of glutathione, oxidized glutathione, and isoprostane were measured in blood samples collected immediately before and during the first and fifth minutes of renal allograft reperfusion. Our results demonstrated a significant increase in isoprostane levels in all groups. Interestingly, in DGF patients, significantly lower levels of perioperative activity of catalase (p<0.02) and GST (p<0.02) were observed. Moreover, in our study, the activity of platelet antioxidants was associated with intensity of perioperative oxidative stress. For discriminating SGF/DGF from EGF, sensitivity, specificity, and positive and negative predictive values of platelet antioxidants were 81-91%, 50-58%, 32-37%, and 90-90.5%, respectively.

CONCLUSIONS

During renal transplantation, significant changes occur in the activity of platelet antioxidants. These changes seem to be associated with post-transplant graft function and can be potentially used to differentiate between EGF and SGF/DGF. To the best of our knowledge, this is the first study to reveal the potential protective role of platelets in the human transplantation setting.

摘要

背景

最近的研究表明,血小板的作用可能会对器官移植物的移植后功能产生不利影响。在这项研究中,研究人员检查了肾移植受者中早期(EGF)、缓慢(SGF)和延迟移植物功能(DGF)组之间移植后移植物功能与血小板抗氧化剂围手术期活性之间的关系。

方法/主要发现:在肾移植再灌注的第一和第五分钟立即采集血样,测定超氧化物歧化酶、过氧化氢酶、谷胱甘肽转移酶(GST)、谷胱甘肽过氧化物酶和葡萄糖-6-磷酸脱氢酶(G6P)的活性,并测定谷胱甘肽、氧化谷胱甘肽和异前列烷的水平。我们的结果表明,所有组的异前列烷水平均显著增加。有趣的是,在 DGF 患者中,观察到围手术期过氧化氢酶(p<0.02)和 GST(p<0.02)活性显著降低。此外,在我们的研究中,血小板抗氧化剂的活性与围手术期氧化应激的强度相关。对于区分 SGF/DGF 和 EGF,血小板抗氧化剂的敏感性、特异性、阳性预测值和阴性预测值分别为 81-91%、50-58%、32-37%和 90-90.5%。

结论

在肾移植过程中,血小板抗氧化剂的活性发生显著变化。这些变化似乎与移植后移植物功能有关,并可能用于区分 EGF 和 SGF/DGF。据我们所知,这是第一项揭示血小板在人类移植环境中潜在保护作用的研究。

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