Biasioli S, Schiavon R, Petrosino L, Cavallini L, Zambello A, De Fanti E, Giavarina D
Nephrology and Dialysis Unit, Legnago Hospital, Italy.
ASAIO J. 1997 Sep-Oct;43(5):M766-72.
Patients with end-stage renal disease (ESRD) who undergo hemodialysis manifest pronounced oxidative stress (OS), for the antioxidant system is inadequate to correct the imbalance between generation and scavenging of reactive oxygen species (ROS). To clarify the role of two different membranes on the OS, we measured plasma lipid peroxidation (LPO) and erythrocyte concentration of several antioxidant enzymes on 20 controls and 6 patients on bicarbonate dialysis (BHD). At 7 days intervals, 2 BHD sessions were done on the same 6 hemodialysis patients: the two BHD sessions were similar, except for the membrane used (cuprophan, first study; regenerated cellulose = Bioflux, second study, 7 days later). Before, during, and after each session (0', 30', 60', 120', end, 30' after BHD end), several blood samples were drawn. Lipid peroxidation and erythrocyte glutathione (GSH), superoxide dismutase (SOD), and catalase were spectrophotometrically determined (Bioxytech, France), but for erythrocyte glutathione peroxidase (Gpx) and G-6-PD, Gunzler's and Beutler's methods were used, respectively. Both membranes induce a significant decrease in LPO (p < 0.01) and an increase in erythrocyte SOD (p < 0.05). Bioflux shows some peculiar effects: a significant increase in erythrocyte GSH (p < 0.05) and erythrocyte catalase (p < 0.01) with a gradual increase of erythrocyte SOD and catalase/SOD ratio. Cuprophan, on the contrary, causes a sudden increase in erythrocyte SOD, while erythrocyte catalase decreases. These data support the view that Bioflux induces an OS lower than cuprophan because with the former, increased H2O2 production leads (thanks to catalase and GPx action) to water generation. With cuprophan, instead the reduced SOD/catalase ratio causes a greater H2O2 generation and a lower conversion to water.
接受血液透析的终末期肾病（ESRD）患者表现出明显的氧化应激（OS），因为抗氧化系统不足以纠正活性氧（ROS）生成与清除之间的失衡。为了阐明两种不同透析膜对氧化应激的作用，我们测定了20名对照者以及6名接受碳酸氢盐透析（BHD）患者的血浆脂质过氧化（LPO）水平和几种抗氧化酶的红细胞浓度。每隔7天，对同一6名血液透析患者进行2次BHD治疗：除了使用的透析膜不同（第一次研究使用铜仿膜；第二次研究，7天后使用再生纤维素膜即Bioflux膜）外，两次BHD治疗相似。在每次治疗前、治疗期间和治疗后（0分钟、30分钟、60分钟、120分钟、治疗结束时、BHD结束后30分钟），采集多份血样。采用分光光度法（法国Bioxytech公司）测定脂质过氧化水平以及红细胞谷胱甘肽（GSH）、超氧化物歧化酶（SOD）和过氧化氢酶的含量，但红细胞谷胱甘肽过氧化物酶（Gpx）和葡萄糖-6-磷酸脱氢酶（G-6-PD）分别采用Gunzler法和Beutler法测定。两种透析膜均能显著降低LPO水平（p < 0.01）并提高红细胞SOD水平（p < 0.05）。Bioflux膜显示出一些特殊作用：红细胞GSH水平显著升高（p < 0.05），红细胞过氧化氢酶水平显著升高（p < 0.01），同时红细胞SOD和过氧化氢酶/ SOD比值逐渐升高。相反，铜仿膜会使红细胞SOD突然升高，而红细胞过氧化氢酶水平降低。这些数据支持以下观点：Bioflux膜诱导的氧化应激低于铜仿膜，因为使用前者时，过氧化氢生成增加（由于过氧化氢酶和GPx的作用）会导致生成水。而使用铜仿膜时，SOD/过氧化氢酶比值降低会导致更多的过氧化氢生成，且向水的转化减少。
