Increased Serum Concentrations of Intestinal Alkaline Phosphatase in Peritoneal Dialysis

Zetterberg, Henrik

doi:10.1373/clinchem.2004.045831

Cited by 7 publications

(5 citation statements)

References 6 publications

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“…Studies of the isozyme composition of serum ALP revealed that levels of IALP activity are considerably increased in patients with CKD [97][98][99][100][101] . CKD might thus be a suitable model for further clinical and experimental studies on the biological significance of IALP.…”

Section: Ialp Inflammation and The Metabolic Syndromementioning

confidence: 99%

Alkaline phosphatase: a novel treatment target for cardiovascular disease in CKD

et al. 2017

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Cardiovascular disease is the main cause of early death in the settings of chronic kidney disease (CKD), type 2 diabetes mellitus (T2DM), and ageing. Cardiovascular events can be caused by an imbalance between promoters and inhibitors of mineralization, which leads to vascular calcification. This process is akin to skeletal mineralization, which is carefully regulated and in which isozymes of alkaline phosphatase (ALP) have a crucial role. Four genes encode ALP isozymes in humans. Intestinal, placental and germ cell ALPs are tissue-specific, whereas the tissue-nonspecific isozyme of ALP (TNALP) is present in several tissues, including bone, liver and kidney. TNALP has a pivotal role in bone calcification. Experimental overexpression of TNALP in the vasculature is sufficient to induce vascular calcification, cardiac hypertrophy and premature death, mimicking the cardiovascular phenotype often found in CKD and T2DM. Intestinal ALP contributes to the gut mucosal defence and intestinal and liver ALPs might contribute to the acute inflammatory response to endogenous or pathogenic stimuli. Here we review novel mechanisms that link ALP to vascular calcification, inflammation, and endothelial dysfunction in kidney and cardiovascular diseases. We also discuss new drugs that target ALP, which have the potential to improve cardiovascular outcomes without inhibiting skeletal mineralization.

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Section: Ialp Inflammation and The Metabolic Syndromementioning

confidence: 99%

Alkaline phosphatase: a novel treatment target for cardiovascular disease in CKD

et al. 2017

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“…Less known is that hypervolemia or diastolic dysfunction in CKD (mainly dialysis patients) may increase total AP, probably by subclinical liver congestion and therefore not representing bone formation activity [14]. Moreover, one cannot always assume that if other hepatic enzymes (such as gamma-glutamyltransferase) are normal, increased total AP is from bone; thus, it has also been described that intestinal AP may be increased in hemodialysis patients [15][16][17][18]. Intestinal AP is an emerging field on clinical research as this AP isoenzyme has important functions in gut mucosal defense [19].…”

Section: Relation Between Total Aps Bsap Pth and Bone Turnovermentioning

confidence: 99%

Alkaline Phosphatases in the Complex Chronic Kidney Disease-Mineral and Bone Disorders

et al. 2018

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Alkaline phosphatases (APs) remove the phosphate (dephosphorylation) needed in multiple metabolic processes (from many molecules such as proteins, nucleotides, or pyrophosphate). Therefore, APs are important for bone mineralization but paradoxically they can also be deleterious for other processes, such as vascular calcification and the increasingly known cross-talk between bone and vessels. A proper balance between beneficial and harmful activities is further complicated in the context of chronic kidney disease (CKD). In this narrative review, we will briefly update the complexity of the enzyme, including its different isoforms such as the bone-specific alkaline phosphatase or the most recently discovered B1x. We will also analyze the correlations and potential discrepancies with parathyroid hormone and bone turnover and, most importantly, the valuable recent associations of AP's with cardiovascular disease and/or vascular calcification, and survival. Finally, a basic knowledge of the synthetic and degradation pathways of APs promises to open new therapeutic strategies for the treatment of the CKD-Mineral and Bone Disorder (CKD-MBD) in the near future, as well as for other processes such as sepsis, acute kidney injury, inflammation, endothelial dysfunction, metabolic syndrome or, in diabetes, cardiovascular complications. However, no studies have been done using APs as a primary therapeutic target for clinical outcomes, and therefore, AP's levels cannot yet be used alone as an isolated primary target in the treatment of CKD-MBD. Nonetheless, its diagnostic and prognostic potential should be underlined.

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“…B and O (secretor) (3,(8)(9)(10)(11)(12)(13). The positivity rate of this band was high in diseases with a high positivity rate of ALP 5 , and the appearance in LC has been most frequently reported (8,12,14). Its appearance in diabetes (9) and renal failure (9,14) has also been reported.…”

Section: Discussionmentioning

confidence: 98%

High‐molecular intestinal alkaline phosphatase in chronic liver diseases

Ooi

Shiraki

Morishita

et al. 2007

Clinical Laboratory Analysis

184

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The presence of high-molecular intestinal alkaline phosphatase (HIALP) different from bone ALP detected in the alpha(2)beta region was recently clarified. In this study we used a novel method in which HIALP was detected after conversion to ALP(5) by protease to investigate the clinical significance of the appearance of HIALP in patients with chronic liver disease. The subjects were 241 patients with chronic liver disease. When a decrease in ALP(3) in the alpha(2)beta region and an increase in ALP(5) in the beta region were noted, the patient was judged HIALP-positive. In the patients with chronic liver disease, the total ALP activity (T-ALP) increased with progression of the pathology in the order of chronic hepatitis (CH), liver cirrhosis (LC), and hepatocellular carcinoma (HCC). HIALP appeared in 22.4% and 49.3% of patients with CH and LC, respectively, but the positivity rate decreased to 30.4% in HCC. As autoimmune liver diseases, primary biliary cirrhosis (PBC) and autoimmune hepatitis (AIH) were investigated. T-ALP was lower in PBC+AIH than in LC and HCC, but the HIALP-positive rate was high (44.4%). The HIALP-positive rate was dependent on ABO blood groups, and was high in blood groups B and O. In conclusion, the HIALP-positive rate was particularly high in patients with chronic liver disease, and was related to the pathological progression, which suggests that the method is clinically useful.

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Increased Serum Concentrations of Intestinal Alkaline Phosphatase in Peritoneal Dialysis

Cited by 7 publications

References 6 publications

Alkaline phosphatase: a novel treatment target for cardiovascular disease in CKD

Alkaline phosphatase: a novel treatment target for cardiovascular disease in CKD

Alkaline Phosphatases in the Complex Chronic Kidney Disease-Mineral and Bone Disorders

High‐molecular intestinal alkaline phosphatase in chronic liver diseases

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