Buradasınız

Pentraksin-3 Kronik Böbrek Hastalığında C-Reaktif Proteinden Daha Güçlü Bir Enflamasyon Belirteci midir?

Is Pentraxin-3 a Stronger Marker of Inflammation than C-Reactive Protein in Chronic Kidney Disease?

Journal Name:

Publication Year:

DOI: 
10.5262/tndt.2014.1002.09

Keywords (Original Language):

Abstract (2. Language): 
OBJECTIVE : Pentraxin-3 (PTX-3) is elevated in uremic patients and related with albuminuria and endothelial dysfunction. We aimed to clarify the relationship of PTX-3 with inflammatory markers (hsCRP and IL-6) in patients with chronic kidney disease (CKD). MATER IAL and MET HODS: The study was performed with four groups: hemodialysis (HD) group (23 patients), peritoneal dialysis (PD) group (25 patients), predialysis group (stage-4 CKD, 25 patients) and the healthy control group (18 individuals). GFR was estimated by the MDRD formula. PTX-3, IL- 6, fibrinogen, hsCRP levels, glucose, urea, creatinine, uric acid, parathyroid hormone, albumin, LDL cholesterol, HDL cholesterol, triglyceride, ferritin, and hemoglobin were studied from the serum and whole blood samples. RE SULT S: PTX-3 levels were highest in the HD group followed by the PD group, pre-dialysis group and control group (3.58±4.29, 2.15±2.75, 1.29±2.36, 0.73±0.96 ng/ml, respectively). IL-6 levels were highest in the PD group followed by the HD, predialysis and control groups. There was no difference between groups regarding hsCRP levels. There was no correlation of PTX-3 with hsCRP, while it was correlated with IL-6. IL-6 was the only determinant of PTX-3 level independent of the study groups and vice versa. CONCLUSION: Uremic patients have elevated PTX-3 levels and it is strongly correlated with IL-6. PTX-3 may be superior to CRP as an inflammation marker in the uremic population.
Abstract (Original Language): 
AMAÇ: Pentraksin-3 (PTX-3) düzeyleri üremik hastalarda yüksektir ve hem albüminüri ile hem de endotelyal disfonksiyonla ilişkilidir. Bu çalışmada, kronik böbrek hastalığı (KBH) olan hastalarda PTX-3’ün enflamatuvar belirteçler (hsCRP ve IL-6) ile arasındaki ilişkiyi araştırmayı amaçladık. GERE Ç ve YÖNTE MLER : Çalışma 4 grupta yapıldı: hemodiyaliz (HD) grubu (23 hasta), periton diyalizi (PD) grubu (25 hasta), prediyaliz grubu (evre-4 KBH, 25 hasta) ve sağlıklı kontrol grubu (18 kişi). Glomerüler filtrasyon hızı (GFH), MDRD formülüne göre hesaplandı. Serum ve tam kan örneklerinden; PTX-3, IL-6, fibrinojen, hsCRP düzeyleri, glukoz, üre, kreatinin, ürik asit, paratiroid hormonu, albümin, LDL kolesterol, HDL kolesterol, trigliserid, ferritin, hemoglobin düzeyleri çalışıldı. BULGULAR: PTX-3 düzeyi HD grubunda en yüksek idi, onu PD, prediyaliz ve kontrol grupları izledi (sırasıyla 3,58±4,29, 2,15±2,75, 1,29±2,36, 0,73±0,96 ng/ml). IL-6 seviyeleri PD grubunda en yüksek idi, ardından HD grubu, prediyaliz ve kontrol grupları izledi. hsCRP düzeylerinde gruplar arasında anlamlı bir fark yoktu. PTX-3 ile IL-6 arasında anlamlı korelasyon izlenirken, PTX-3 ile hsCRP arasında ilişki saptanmadı. IL-6 çok değişkenli analizde PTX-3’ün tek bağımsız belirleyicisi olarak bulunurken, IL-6’nın tek bağımsız belirleyicisi de PTX-3 idi. SONUÇ: Üremik hastalarda PTX-3 düzeyleri yükselmiştir ve IL-6 ile kuvvetli ilişki göstermektedir. PTX-3, üremik popülasyonda bir enflamasyon belirteci olarak hsCRP’den üstün olabilir.
131
136

REFERENCES

References: 

1. Vanholder R, Massy Z, Argiles A, Spasovski G, Verbeke F, Lamiere
N: Chronic kidney disease as a cause of cardiovascular morbidity
and mortality. Nephrol Dial Transpl 2005; 20: 1048-1056
2. Ross R: Atherosclerosis-an inflammatory disease. N Engl J Med
1999; 340: 115-126
3. Hansson GK: Inflammation, atherosclerosis and coronary artery
disease. N Engl J Med 2005; 352: 1685-1695
4. Methe H, Edelman ER: Cell-matrix contact prevents recognition
and damage of endothelial cells in states of heightened immunity.
Circulation 2006; 114 (Suppl 1): 1233-1238
5. Kofler S, Nickel T, Weis M: Role of cytokines in cardiovascular
diseases: A focus on endothelial responses to inflammation. Clin Sci
2005; 108: 205-213
6. Tong M, Carrero JJ, Qureshi AR, Anderstam B, Heimbürger
O, Bárány P, Axelsson J, Alvestrand A, Stenvinkel P, Lindholm
B, Suliman ME: Plasma pentraxin-3 in chronic kidney disease
patients: Associations with renal function, protein-energy wasting,
cardiovascular disease and mortality. Clin J Am Soc Nephrol 2007;
2: 889-8977. Pecoitz-Filho R, Barany B, Lindholm B, Heimbürger O, Stenvinkel
P: Interleukin-6 and its receptor is an independent predictor of
mortality in patients starting dialysis treatment. Nephrol Dial
Transpl 2002; 17: 1684-1688
8. Chiang CK, Hsu HP, Pai MF, Peng YS, Ho TI, Liu SH, Hung KY,
Tsai TJ: Interlekin-18 is a strong predictor of hospitalization in
hemodialysis patients. Nephrol Dial Transpl 2004; 19: 2810-2815
9. Zoccali C, Mallamaci F, Tripepi G, Cutrupi S, Parlongo S, Malatino
LS, Bonanno G, Rapisarda F, Fatuzzo P, Seminara G, Stancanelli
B, Nicocia G, Buemi M: Fibrinogen, mortality and incident
cardiovascular complications in end-stage renal failure. J Intern
Med 2003; 254: 132-139
10. Zimmermann J, Herrlinger S, Pruy A, Metzger T, Wanner C:
Inflammation enhances cardiovascular risk and mortality in
hemodialysis patients. Kidney Int 1999; 55: 648-658
11. Filiopoulos V, Vlassopoulos D: Inflammatory syndrome in chronic
kidney disease: Pathogenesis and influence on outcomes. Inflamm
Allergy Drug Targets 2009; 8: 369-382
12. Schlieper G, Brandenburg V, Djuric Z, Damjanovic T, Markovic
N, Westenfeld R, Dimkovic N, Ketteler M, Floege J: Is there a
correlation between C-reactive protein and calcification inhibitors
with cardiovascular parameters and risk factors in hemodialysis
patients? Dtsch Med Wochenschr 2007; 132: 1820-1824
13. Kovacs A, Tornvall P, Nilsson R, Tegner J, Hamsten A, Björkegren:
Human C-reactive protein slows atherosclerosis development in a
mouse model with human-like hypercholesterolemia. J Proc Natl
Acad Sci USA 2007; 104: 13768-13773
14. Suliman M, Stenvinkel P, Qureshi AR, Kalantar-Zadeh K, Bárány P,
Heimbürger O, Vonesh EF, Lindholm B: The reverse epidemiology
of plasma total homocystein as a mortality risk factor is related
to the impact of wasting and inflammation. Nephrol Dial Transpl
2007; 22: 209-217
15. Suliman ME, Barany P, Kalantar-Zadeh K, Lindholm B, Stenvinkel
P: Homocystein in uraemia: A puzzling and conflicting story.
Nephrol Dial Transpl 2005; 20: 16-21
16. Mantovani A, Garlanda C, Bottazzi B, Peri G, Doni A, Martinez de
la Torre Y, Latini R: The long pentraxin PTX3 in vascular pathology.
Vascul Pharmacol 2006; 45: 326-330
17. Nauta AJ, de Haij S, Bottazzi B, Mantovani A, Borrias MC, Aten
J, Rastaldi MP, Daha MR, van Kooten C, Roos A: Human renal
epithelial cells produce the long pentraxin PTX3. Kidney Int 2005;
67: 543-55318. Boehme M, Kaehne F, Kuehne A, Bernhardt W, Schröder M,
Pommer W, Fischer C, Becker H, Müller C, Schindler R: Pentraxin
3 is elevated in hemodialysis patients and is associated with
cardiovascular disease. Nephrol Dial Int 2007; 22: 2224-2229
19. Suliman ME, Qureshi AR, Carrero JJ, Bárány P, Yilmaz MI,
Snaedal-Jonsdottir S, Alvestrand A, Heimbürger O, Lindholm B,
Stenvinkel P: The long pentraxin PTX-3 in prevalent hemodialysis
patients: Associations with co-morbidities and mortality. QJM
2008; 101: 397-405
20. Malaponte G, Libra M, Bevelacqua Y, Merito P, Fatuzzo P, Rapisarda
F, Cristina M, Naselli G, Stivala F, Mazzarino MC, Castellino P:
Inflammatory status in patients with chronic renal failure: The role
of PRX3 and pro-inflammatory cytokines. Int J Mol Med 2007; 20:
471-481
21. Muller B, Peri G, Torri V, Landmann R, Bottazzi B, Mantovani
A: Circulating levels of long pentraxin PTX3 correlate with the
severity of infection in critically ill patients. Crit Care Med 2001;
29: 1404-1407
22. Suliman ME, Yilmaz MI, Carrero JJ, Qureshi AR, Saglam M,
Ipcioglu OM, Yenicesu M, Tong M, Heimbürger O, Barany P,
Alvestrand A, Lindholm B, Stenvinkel P: Novel links between the
long pentraxin-3, endothelial dysfunction, and albuminuria in early
and advanced chronic kidney disease. Clin J Am Soc Nephrol 2008;
3: 976-985
23. Kalantar-Zadeh K: Inflammatory marker mania in chronic kidney
disease: Pentraxins at the crossroad of universal soldiers of
inflammation. Clin J Am Soc Nephrol 2007; 2: 872-875
24. Şahin E, Bulucu F, Karaman M, Ay AS, Sağlam M, Çakir E,
Yilmaz Mİ: The Relationship between endothelial dysfunction
and pentraxin-3 concentration in chronic kidney disease. Turkish
Nephrology, Dialysis and Transplantation Journal 2010; 19: 192-
198
25. Pawlak K, Pawlak D, Mysliwiec M: Impaired renal function and
duration of dialysis therapy are associated with oxidative stress
and proatherogenic cytokine levels in patients with end-stage renal
disease. Clin Biochem 2007; 40: 81-85
26. Diefenbach CW, Tramont EC, Plaeger SF: Section B: Host
Defense Mechanisms. Innate (general or nonspecific) host defense
mechanisms. In: Mandell GL, Bennett JE, Dolin R (eds), Mandell,
Douglas and Bennet’s Principles and Practice of Infectious Diseases.
(Fifth ed). Newyork: Chuchill Livingstone, 2009
27. Lysaght MJ, Pollock CA, Moran JE, Ibels LS, Farrell PC: Beta-
2 microglobulin removal during continuous ambulatory peritoneal
dialysis (CAPD). Perit Dial Int 1989; 9: 29-35

Thank you for copying data from http://www.arastirmax.com