Department of Nephrology, Dialysis and Transplantation, St Bortolo Hospital, International Renal Research Institute Vicenza, Via Rodolfi, 37, 36100, Vicenza, Italy.
IRRIV-International Renal Research Institute Vicenza, Vicenza, Italy.
J Nephrol. 2019 Oct;32(5):803-810. doi: 10.1007/s40620-019-00613-2. Epub 2019 Apr 20.
BACKGROUND: Cardiorenal syndrome type 1 (CRS type 1) is characterized by a rapid worsening of cardiac function leading to acute kidney injury. In this study, we evaluate the role of lipopolysaccharide (LPS) and various inflammatory markers in the developing acute kidney injury (AKI) in acute heart failure (AHF) patients. METHODS: We enrolled 31 AHF patients and 20 CRS type 1 (the cause of AKI was presumed to be related to cardiac dysfunction) and 17 healthy volunteers without AHF, AKI or CKD, as control group (CTR). We assessed levels of LPS, proinflammatory cytokines (TNF-α, IL-6, IL-18), and oxidative stress marker (myeloperoxidase, MPO). RESULTS: We observed a significant increase in LPS, TNF-α, IL-6, IL-18 and MPO levels in CRS type 1 and AHF group compared to CTR. LPS levels resulted significantly higher in CRS type 1 patients compared with AHF (118.2 pg/mL, IQR 77.8-217.6 versus 13.5 pg/mL, IQR 12.0-17.0, p = 0.008). We found a cytokines and oxidative stress dysregulation in CRS type 1 patients compared with AHF. Furthermore, we observed a strong positive significant correlation between LPS levels and IL-6 (Spearman's rho = 0.79, p < 0.001), and IL-18 (Spearman's rho = 0.77, p < 0.001) and MPO (Spearman's rho = 0.80, p < 0.001), all confirm by simple linear regression analysis. CONCLUSION: CRS type 1 patients presented an increased level of LPS, pro-inflammatory cytokines, and MPO. Furthermore, there is a direct correlation between LPS and pro-inflammatory cytokines and stress oxidative marker. LPS may play a role in the pathophysiology of CRS type 1 inducing inflammation, oxidative stress and finally kidney damage.
背景：1 型心肾综合征（CRS 型 1）的特征是心脏功能迅速恶化，导致急性肾损伤。在这项研究中，我们评估了脂多糖（LPS）和各种炎症标志物在急性心力衰竭（AHF）患者发展为急性肾损伤（AKI）中的作用。
方法：我们纳入了 31 名 AHF 患者和 20 名 CRS 型 1 患者（AKI 的原因被认为与心功能障碍有关）以及 17 名无 AHF、AKI 或 CKD 的健康志愿者作为对照组（CTR）。我们评估了 LPS、促炎细胞因子（TNF-α、IL-6、IL-18）和氧化应激标志物（髓过氧化物酶，MPO）的水平。
结果：我们观察到 CRS 型 1 和 AHF 组的 LPS、TNF-α、IL-6、IL-18 和 MPO 水平显著升高，与 CTR 相比。CRS 型 1 患者的 LPS 水平明显高于 AHF 患者（118.2 pg/mL，IQR 77.8-217.6 与 13.5 pg/mL，IQR 12.0-17.0，p=0.008）。与 AHF 相比，我们发现 CRS 型 1 患者存在细胞因子和氧化应激失调。此外，我们观察到 LPS 水平与 IL-6（Spearman's rho=0.79，p<0.001）和 IL-18（Spearman's rho=0.77，p<0.001）以及 MPO（Spearman's rho=0.80，p<0.001）之间存在强正相关，所有这些都通过简单线性回归分析得到证实。
结论：CRS 型 1 患者的 LPS、促炎细胞因子和 MPO 水平升高。此外，LPS 与促炎细胞因子和氧化应激标志物之间存在直接相关性。LPS 可能在 CRS 型 1 的病理生理学中发挥作用，导致炎症、氧化应激和最终的肾损伤。
Cardiorenal Med. 2019-6-25
Oxid Med Cell Longev. 2015
Cardiorenal Med. 2021
Cardiorenal Med. 2018-5-30
BMC Cardiovasc Disord. 2017-7-26
Diagnostics (Basel). 2024-9-23
Diagnostics (Basel). 2022-12-27
Front Cardiovasc Med. 2021-12-14
Front Cell Dev Biol. 2021-3-22
Cardiorenal Med. 2018-5-30
Blood Purif. 2017-11-22
Cardiorenal Med. 2017-10
Kidney Blood Press Res. 2016
Oxid Med Cell Longev. 2015
Zotero 插件