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一项评估乳铁蛋白+鸟苷单磷酸二钠疗法对慢性肾脏病患者抗炎作用的临床研究。

A Clinical Study to Evaluate the Anti-inflammatory Effect of Lactoferrin + Disodium Guanosine Monophosphate Therapy in the Patients with Chronic Kidney Disease.

作者信息

Yadav Rajkanwar, Sangha Sukhwinder Singh, Yadav Sushma, Sharma Preeti, Shah Harsh, Bhowmik Dipankar

机构信息

Additional Professor, Department of Nephrology, All India Institute of Medical Sciences, Delhi, India, Corresponding Author.

Assistant Professor, Department of Nephrology, Command Hospital, Panchkula, Haryana, India.

出版信息

J Assoc Physicians India. 2025 Jan;73(1):18-22. doi: 10.59556/japi.73.0757.

Abstract

INTRODUCTION

India is impacted by the increasing burden of chronic kidney disease (CKD) and end-stage renal disease (ESRD), necessitating efficient management and therapy. CKD is characterized by elevated levels of inflammatory biomarkers, specifically IL-1β, IL-1RA, IL-6, TNF-α, TGF-β, and fibrinogen. The aim of this research is to determine the antiinflammatory effects of lactoferrin + disodium guanosine monophosphate therapy in CKD patients. The objective of this study is to examine the efficacy of this therapy versus conservative CKD management alone in reducing inflammation. This study intends to examine the possible benefits of study drug in treating inflammation associated with CKD by analyzing its effect on inflammatory markers including IL-6 and TNF-α.

METHODS

This randomized, open-label, parallel group, two-arm clinical study, comprising of 40 patients with CKD, with 20 patients in each group. The groups were well-matched in terms of demographic characteristics. Conception, screening, randomization, and follow-up visits including physical examinations, laboratory investigations, and medication dispensation were all carried out over a 29-week period. Creatinine clearance, estimated glomerular filtration rate (eGFR), estimated urine urea nitrogen, and inflammatory markers (IL-6, IL-10, TNF-α, CRP) were analyzed at time of screening and at 3 and 6-month postrandomization.

RESULTS

The study found a significant decrease in inflammatory markers, including TNF-α, IL-6, and IL-10, in the group receiving study drug, indicating its potential as an antiinflammatory intervention for managing CKD. Secondary endpoints, including hemoglobin (Hb) and e-GFR levels, showed nonsignificant improvements in the study group compared to the control group. No significant adverse events were reported during the study.

CONCLUSION

The study highlights the potential antiinflammatory effects of the lactoferrin + disodium guanosine monophosphate therapy in individuals with CKD. The findings suggest that study drug may be a viable intervention for managing inflammation in CKD patients. Further research is needed to validate these results and explore its long-term effects in CKD management.

摘要

引言

印度正受到慢性肾脏病(CKD)和终末期肾病(ESRD)日益加重的负担的影响,因此需要有效的管理和治疗。CKD的特征是炎症生物标志物水平升高,特别是白细胞介素-1β(IL-1β)、白细胞介素-1受体拮抗剂(IL-1RA)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、转化生长因子-β(TGF-β)和纤维蛋白原。本研究的目的是确定乳铁蛋白+鸟苷单磷酸二钠疗法对CKD患者的抗炎作用。本研究的目的是检验该疗法与单纯CKD保守治疗相比在减轻炎症方面的疗效。本研究旨在通过分析其对包括IL-6和TNF-α在内的炎症标志物的影响,研究受试药物在治疗与CKD相关的炎症方面可能的益处。

方法

这是一项随机、开放标签、平行组、双臂临床研究,包括40例CKD患者,每组20例。两组在人口统计学特征方面匹配良好。受孕、筛查、随机分组以及包括体格检查、实验室检查和药物分发在内的随访均在29周内进行。在筛查时以及随机分组后3个月和6个月时分析肌酐清除率、估计肾小球滤过率(eGFR)、估计尿尿素氮和炎症标志物(IL-6、IL-10、TNF-α、CRP)。

结果

研究发现,接受受试药物治疗的组中,包括TNF-α、IL-6和IL-10在内的炎症标志物显著降低,表明其作为管理CKD的抗炎干预措施的潜力。次要终点,包括血红蛋白(Hb)和e-GFR水平,与对照组相比,研究组显示出无显著改善。研究期间未报告重大不良事件。

结论

该研究突出了乳铁蛋白+鸟苷单磷酸二钠疗法对CKD患者的潜在抗炎作用。研究结果表明,受试药物可能是管理CKD患者炎症的一种可行干预措施。需要进一步研究来验证这些结果,并探索其在CKD管理中的长期效果。

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