Sarnatskaya V V, Ivanov A I, Nikolaev V G, Rotellar E, von Appen K, Haspar M, Maslenny V N, Klinkmann H
Institute of Experimental Pathology, Oncology and Radiobiology, National Academy of Sciences, Kiev, Ukraine.
Artif Organs. 1998 Feb;22(2):107-15.
Few diagnostic methods are available that describe uremia related changes of the albumin molecule structure in hemodialysis patients. The impaired human serum albumin (HSA) function is an essential part of the uremic syndrome and probably influences the long-term outcome of patients on maintenance dialysis. The albumin binding capacity (characterized for different binding centers on the molecule) is one of the relevant clinical parameters. During the current study, marker substances were utilized to evaluate center-specific binding capacity. Patients were divided into 3 groups depending on the time on hemodialysis (HD) treatment (in years) with healthy blood donors as control. Compared to healthy persons, results demonstrate a considerable impairment of binding characteristics in HD patients. Only in patients on maintenance HD for more than 5 years did ligand binding properties improve significantly. A correlation between the time of chronic HD and the recovery in binding capacity was found for the majority of binding centers of the HSA molecule. Similar results were seen applying such analytical methods as thermography (melting points) and thermofluorescence. Binding capacity impairment found for specified binding centers on the HSA molecule as the main serum carrier protein may have a direct impact on different clinical situations and the HD long-term outcome.
目前几乎没有诊断方法能够描述血液透析患者中与尿毒症相关的白蛋白分子结构变化。人血清白蛋白（HSA）功能受损是尿毒症综合征的一个重要部分，可能会影响维持性透析患者的长期预后。白蛋白结合能力（针对分子上不同的结合中心进行表征）是相关的临床参数之一。在本研究中，使用标记物质来评估特定中心的结合能力。根据血液透析（HD）治疗时间（以年为单位）将患者分为3组，并以健康献血者作为对照。与健康人相比，结果表明HD患者的结合特性有相当大的损害。只有维持HD治疗超过5年的患者，其配体结合特性才显著改善。对于HSA分子的大多数结合中心，发现慢性HD时间与结合能力的恢复之间存在相关性。应用热成像（熔点）和热荧光等分析方法也得到了类似的结果。作为主要血清载体蛋白的HSA分子上特定结合中心的结合能力受损，可能会对不同的临床情况和HD长期预后产生直接影响。
