Department of Nephrology, Hypertension and Family Medicine, Medical University, Łódź, Poland.
Med Sci Monit. 2013 Nov 8;19:954-9. doi: 10.12659/MSM.884024.
There is data in the literature indicating increased oxidative stress in chronic kidney disease (CKD). Erythropoiesisstimulating agents (ESAs), which are commonly used to treat anemia in patients with CKD, seem to have an antioxidant action, which could be a part of nephroprotection. The aim of the current study was to investigate the effect of a long half-life ESA, methoxy polyethylene glycol-epoetin beta (Mircera), on some markers of oxidative stress in predialysis patients with CKD.
Peripheral blood was collected from 28 predialysis CKD patients 2 times, before Mircera treatment and after achieving target hemoglobin (Hb), and 15 healthy subjects (control group). Superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), and catalase (CAT) activity in erythrocytes were measured according to commonly used methods as a function of the antioxidant defense system. To assess reactive oxygen species (ROS) production, malondialdehyde (MDA) concentration in erythrocytes and in plasma was measured according to a commonly used method.
SOD, GSH-Px, and CAT activity were similar, but plasma and erythrocyte MDA concentrations were significantly higher in CKD patients before ESA treatment in comparison to the control group. SOD, GSH-Px, and CAT activity was significantly higher, but plasma and erythrocyte MDA concentrations were significantly lower, in CKD patients after ESA treatment in comparison to these patients before treatment. We did not find a significant correlation between Hb concentration and SOD, GSH-Px, and CAT activity and plasma, as well as erythrocyte MDA concentrations. Analysis of all investigated groups showed a significant negative correlation between Hb concentration and plasma MDA concentration.
Our results suggest that treatment of anemia with methoxy polyethylene glycol-epoetin beta may inhibit oxidative stress in predialysis patients with CKD by enhancing the antioxidant defense system and reducing ROS production.
文献中有数据表明，慢性肾脏病（CKD）患者的氧化应激增加。促红细胞生成素刺激剂（ESA）常用于治疗 CKD 患者的贫血，似乎具有抗氧化作用，这可能是肾脏保护的一部分。本研究旨在探讨长半衰期 ESA 甲氧基聚乙二醇-促红细胞生成素β（Mircera）对 CKD 透析前患者某些氧化应激标志物的影响。
采集 28 例 CKD 透析前患者 2 次外周血，分别在 Mircera 治疗前和达到目标血红蛋白（Hb）后，以及 15 例健康受试者（对照组）。根据常用方法测定红细胞中超氧化物歧化酶（SOD）、谷胱甘肽过氧化物酶（GSH-Px）和过氧化氢酶（CAT）的活性，作为抗氧化防御系统的功能。为了评估活性氧（ROS）的产生，根据常用方法测定红细胞和血浆中丙二醛（MDA）的浓度。
SOD、GSH-Px 和 CAT 活性相似，但 CKD 患者在 ESA 治疗前的血浆和红细胞 MDA 浓度明显高于对照组。ESA 治疗后 CKD 患者的 SOD、GSH-Px 和 CAT 活性显著升高，而血浆和红细胞 MDA 浓度显著降低。我们没有发现 Hb 浓度与 SOD、GSH-Px 和 CAT 活性以及血浆和红细胞 MDA 浓度之间有显著相关性。对所有研究组的分析表明，Hb 浓度与血浆 MDA 浓度之间存在显著负相关。
我们的研究结果表明，用甲氧基聚乙二醇-促红细胞生成素β治疗贫血可能通过增强抗氧化防御系统和减少 ROS 产生来抑制 CKD 透析前患者的氧化应激。
