Mattinzoli Deborah, Turolo Stefano, Ikehata Masami, Vettoretti Simone, Montini Giovanni, Agostoni Carlo, Conti Costanza, Benedetti Matteo, Messa Piergiorgio, Alfieri Carlo Maria, Castellano Giuseppe
Renal Research Laboratory, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy.
Pediatric Nephrology, Dialysis and Transplant Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy.
J Clin Med. 2023 Sep 12;12(18):5928. doi: 10.3390/jcm12185928.
During chronic kidney disease (CKD) progression, an increase in fibroblast growth factor (FGF23) is present. In stage 5, a positive correlation between FGF23 and omega-6 (n-6) polyunsaturated fatty acids (PUFAs) emerges. Hypothesizing that the rising positive correlation between monocyte chemoattractant protein 1 (MCP1) and n-6 in stage 4 could be the cause, we previously explored FGF23 and MCP1's roles in dyslipidemia and cardiovascular risk in CKD. In the present paper, we retraced the study evaluating 40 kidney transplant patients (KTx), a cohort where several factors might modify the previous relationships found. An ELISA and gas chromatography assessed the MCP1, FGF23, and PUFA levels. Despite the FGF23 increase ( < 0.0001), low MCP1 levels were found. A decrease in the n-6/n-3 ratio ( = 0.042 CKD stage 4 vs. 5) lowered by the increase in both n-3 αlinolenic ( = 0.012) and docosapentaenoic acid ( = 0.049) was observed. A negative correlation between FGF23 and the n-6/n-3 ratio in CKD stage 4 (r -0.3 = 0.043) and none with MCP1 appeared. According to our findings, different mechanisms in the relationship between FGF23, PUFAs, and MCP1 in CKD and KTx patients might be present, which is possibly related to the immunosuppressive status of the last. Future research will further clarify our hypothesis.
在慢性肾脏病（CKD）进展过程中，成纤维细胞生长因子（FGF23）水平会升高。在5期，FGF23与ω-6（n-6）多不饱和脂肪酸（PUFA）之间呈现正相关。鉴于我们之前推测4期单核细胞趋化蛋白1（MCP1）与n-6之间不断上升的正相关可能是其原因，因此我们此前探讨了FGF23和MCP1在CKD血脂异常和心血管风险中的作用。在本文中，我们回顾了一项针对40例肾移植患者（KTx）的研究，在该队列中，一些因素可能会改变之前发现的关系。采用酶联免疫吸附测定法（ELISA）和气相色谱法评估MCP1、FGF23和PUFA水平。尽管FGF23升高（<0.0001），但MCP1水平较低。观察到n-3α-亚麻酸（=0.012）和二十二碳五烯酸（=0.049）均增加，使得n-6/n-3比值降低（4期与5期CKD相比，P=0.042）。在CKD 4期，FGF23与n-6/n-3比值呈负相关（r=-0.3，P=0.043），而与MCP1无相关性。根据我们的研究结果，CKD和KTx患者中FGF23、PUFA和MCP1之间的关系可能存在不同机制，这可能与后者的免疫抑制状态有关。未来的研究将进一步阐明我们的假设。
