Gutierrez A, Alvestrand A, Wahren J, Bergström J
Department of Renal Medicine, Karolinska Institute, Huddinge University Hospital, Stockholm, Sweden.
Kidney Int. 1990 Sep;38(3):487-94. doi: 10.1038/ki.1990.230.
To investigate whether the contact between blood and dialysis membranes might induce muscle protein degradation, the exchange of free amino acids across leg tissues was measured by catheterization technique in three groups of healthy subjects before and after a 150 minute sham-hemodialysis procedure (SHDP), that is, in vivo passage of blood (100 ml/min) through a dialyzer but with no circulating dialysate. Dialyzers with either regenerated cellulose membrane (group CU, N = 10 and group CU-IND, N = 6) or polyacrylonitrile membrane (group AN, N = 8) were used in group CU-IND indomethacin was administered before (100 mg) and at the end (50 mg) of SHDP. Leg blood flow was measured by venous occlusion plethysmography. In group CU net leg release of tyrosine and phenylalanine increased from 3.4 +/- 0.8 and 3.6 +/- 0.8 nmol/min/100 g tissue, respectively, before SHDP to 7.8 +/- 1.8 and 8.3 +/- 1.8 nmol/min/100 g tissue, respectively, at 345 minutes after the start of SHDP (P less than 0.01). The total release of all measured amino acids increased from 148 +/- 31 to 309 +/- 50 nmol/min/100 g tissue (P less than 0.01). The results indicate that interaction between blood and regenerated cellulose membranes leads to accelerated net protein breakdown. In group CU-IND no change in leg amino acid release was observed following SHDP, suggesting that the increased net protein catabolism is mediated by prostaglandins. Sham hemodialysis using AN membranes did not result in increased amino acid efflux from leg tissues, implying that the protein catabolic effect of blood-membrane contact depends on the biochemical properties of dialyser.
为了研究血液与透析膜之间的接触是否会诱导肌肉蛋白质降解，通过导管插入技术测量了三组健康受试者在150分钟的假血液透析程序（SHDP）前后腿部组织中游离氨基酸的交换情况，即血液（100毫升/分钟）在体内通过透析器但无循环透析液。使用了再生纤维素膜的透析器（CU组，N = 10和CU-IND组，N = 6）或聚丙烯腈膜（AN组，N = 8）。在CU-IND组中，在SHDP开始前（100毫克）和结束时（50毫克）给予吲哚美辛。通过静脉阻塞体积描记法测量腿部血流量。在CU组中，SHDP前酪氨酸和苯丙氨酸的腿部净释放量分别从3.4±0.8和3.6±0.8纳摩尔/分钟/100克组织增加到SHDP开始后345分钟时的7.8±1.8和8.3±1.8纳摩尔/分钟/100克组织（P<0.01）。所有测量氨基酸的总释放量从148±31增加到309±50纳摩尔/分钟/100克组织（P<0.01）。结果表明血液与再生纤维素膜之间的相互作用导致净蛋白质分解加速。在CU-IND组中，SHDP后未观察到腿部氨基酸释放的变化，提示净蛋白质分解代谢增加是由前列腺素介导的。使用AN膜的假血液透析未导致腿部组织氨基酸流出增加，这意味着血液-膜接触的蛋白质分解代谢作用取决于透析器的生化特性。
