Department of Internal Medicine, Nowon Eulji University Hospital, Seoul, Korea.
Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Korea.
Yonsei Med J. 2020 Jan;61(1):56-63. doi: 10.3349/ymj.2020.61.1.56.
Elevated aryl hydrocarbon receptor (AhR) transactivating (AHRT) activity and uremia in chronic kidney disease (CKD) may interact with each other, further complicating the disease course. In this study, we prospectively estimated serum AHRT activity using a highly sensitive cell-based AhR-dependent luciferase activity assay in CKD patients and compared differences therein according to treatment modality.
Patients undergoing peritoneal dialysis (PD) (n=22) and hemodialysis (HD) (n=38) and patients with pre-dialysis CKD stage IV or V (n=28) were included. AHRT activity and intracellular adenosine triphosphate (ATP) levels were measured. We performed a correlation analysis for AHRT activity, ATP levels, and various clinical parameters.
AHRT activity and intracellular ATP levels were inversely correlated and differed according to treatment modalities. AHRT activity was higher in non-dialysis CKD patients than in patients undergoing dialysis and was higher in patients undergoing HD, compared to PD. AHRT activity decreased after HD treatment in HD patients. ATP levels were higher in healthy controls than in patients with pre-dialysis CKD and PD and were further decreased in patients with HD. We noted significant correlations between multiple clinical parameters associated with cardiovascular risk factors and AHRT activity.
AHRT activity was elevated in CKD patients, while dialysis treatment reduced AHRT activity. Further studies are warranted to specify AHRT activity and to evaluate the precise roles thereof in patients with CKD.
慢性肾脏病(CKD)患者芳烃受体(AhR)转录激活(AHRT)活性升高和尿毒症可能相互作用,进一步使疾病复杂化。在这项研究中,我们使用高度敏感的基于细胞的 AhR 依赖性荧光素酶活性测定法,前瞻性地估计了 CKD 患者的血清 AHRT 活性,并根据治疗方式比较了其差异。
纳入正在接受腹膜透析(PD)(n=22)和血液透析(HD)(n=38)的患者以及处于透析前 CKD 第四或第五阶段的患者(n=28)。测量了 AHRT 活性和细胞内三磷酸腺苷(ATP)水平。我们对 AHRT 活性、ATP 水平和各种临床参数进行了相关性分析。
AHRT 活性和细胞内 ATP 水平呈负相关,且根据治疗方式而有所不同。与正在接受透析的患者相比,非透析 CKD 患者的 AHRT 活性更高,与 PD 相比,HD 患者的 AHRT 活性更高。HD 患者接受 HD 治疗后,AHRT 活性降低。与 PD 患者和处于透析前 CKD 阶段的患者相比,健康对照组的 ATP 水平更高,而 HD 患者的 ATP 水平进一步降低。我们注意到与心血管危险因素相关的多个临床参数与 AHRT 活性之间存在显著相关性。
CKD 患者的 AHRT 活性升高,而透析治疗降低了 AHRT 活性。需要进一步研究以明确 AHRT 活性,并评估其在 CKD 患者中的确切作用。