Ross E A, Koo L C, Moberly J B
Division of Nephrology, Hypertension and Transplantation, University of Florida, Gainesville 32610-0224, USA.
Am J Kidney Dis. 1997 Oct;30(4):489-94. doi: 10.1016/s0272-6386(97)90306-1.
Dialysis patients are reported to have impaired antioxidant mechanisms, including those involving glutathione-dependent enzymes. This study used high-performance liquid chromatography assays that directly measure total (oxidized + reduced) glutathione and its precursor cysteine (CYS) to compare the whole blood of hemodialysis (prehemodialysis and posthemodialysis) and peritoneal dialysis patients to that of blood donors with no known kidney disease (n=20 in each group). The levels in erythrocytes were calculated from that data (as nmol/g hemoglobin) because these cells are the major compartment of blood glutathione and their survival may be shortened by oxidant damage. Both dialysis groups had significantly (P=0.0001) higher CYS levels in the plasma compartment than the controls (251 nmol/mL), with prehemodialysis levels (432 nmol/mL) being greater than peritoneal dialysis levels (334 nmol/mL). Hemodialysis acutely lowered CYS levels (215 nmol/mL) below those of controls. Expressed per milliliter whole blood, both dialysis groups had significantly (P=0.0001) lower glutathione levels than controls (1,276 nmol/mL), with prehemodialysis and peritoneal dialysis levels being similar (778 and 912 nmol/mL). Values increased prehemodialysis to posthemodialysis, consistent with hemoconcentration. Expressed per gram hemoglobin, the dialysis groups had significantly (P < 0.015) lower glutathione levels than the controls (8,938 nmol/g hemoglobin), with similar prehemodialysis, posthemodialysis, and peritoneal dialysis values (7,207, 7,315, and 7,915 nmol/g hemoglobin, respectively). In summary, hemodialysis and peritoneal dialysis patients are at increased risk from oxidative stress due to glutathione deficiency in whole blood and erythrocytes.
据报道，透析患者的抗氧化机制受损，包括那些涉及谷胱甘肽依赖性酶的机制。本研究使用高效液相色谱分析法直接测量总（氧化型+还原型）谷胱甘肽及其前体半胱氨酸（CYS），以比较血液透析（透析前和透析后）患者和腹膜透析患者的全血与无已知肾脏疾病的献血者的全血（每组n = 20）。根据该数据计算红细胞中的水平（以nmol/g血红蛋白表示），因为这些细胞是血液中谷胱甘肽的主要组成部分，并且它们的存活可能会因氧化损伤而缩短。两个透析组血浆部分的CYS水平均显著高于对照组（P = 0.0001）（对照组为251 nmol/mL），透析前水平（432 nmol/mL）高于腹膜透析水平（334 nmol/mL）。血液透析会使CYS水平急剧降低（215 nmol/mL）至低于对照组水平。以每毫升全血表示，两个透析组的谷胱甘肽水平均显著低于对照组（P = 0.0001）（对照组为1276 nmol/mL），透析前和腹膜透析水平相似（分别为778和912 nmol/mL）。透析前至透析后数值升高，与血液浓缩一致。以每克血红蛋白表示，透析组的谷胱甘肽水平显著低于对照组（P < 0.015）（对照组为8938 nmol/g血红蛋白），透析前、透析后和腹膜透析值相似（分别为7207、7315和7915 nmol/g血红蛋白）。总之，血液透析和腹膜透析患者由于全血和红细胞中谷胱甘肽缺乏，面临氧化应激风险增加。
