Modulation of Myostatin/Hepatocyte Growth Factor Balance by Different Hemodialysis Modalities

Esposito, Pasquale; Porta, Edoardo La; Calatroni, Marta; Grignano, Maria Antonietta; Milanesi, Samantha; Verzola, Daniela; Battaglia, Yuri; Gregorini, Marilena; Libetta, Carmelo; Garibotto, Giacomo; Rampino, Teresa

doi:10.1155/2017/7635459

Cited by 14 publications

(12 citation statements)

References 25 publications

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“…First, we evaluated the circulating levels of Mstn and the potential effect of dialytic treatment on these levels, taking into consideration different dialysis techniques (BHD vs HDF). We found no differences in Mstn levels between HD patients and healthy control, while there was a significant slight decrease of Mstn after a single HD session, confirming our previous data of a potential modulation of serum Mstn by HD treatment [22]. However, in contrast with other reports, we did not observe significant differences in Mstn levels between BHD and HDF [14, 22].…”

Section: Discussionsupporting

confidence: 84%

Significance of serum Myostatin in hemodialysis patients

Esposito¹,

Battaglia²,

Porta³

et al. 2019

BMC Nephrol

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BackgroundMalnutrition and muscle wasting are common in haemodialysis (HD) patients. Their pathogenesis is complex and involves many molecules including Myostatin (Mstn), which acts as a negative regulator of skeletal muscle. The characterisation of Mstn as a biomarker of malnutrition could be useful in the prevention and management of this condition. Previous studies have reported no conclusive results on the actual relationship between serum Mstn and wasting and malnutrition. So, in this study, we evaluated Mstn profile in a cohort of regular HD patients.MethodsWe performed a cross-sectional study, enrolling 37 patients undergoing bicarbonate-HD (BHD) or haemodiafiltration (HDF) at least for six months. 20 sex-matched healthy subjects comprised the control group. Mstn serum levels were evaluated by ELISA before and after HD. We collected clinical and biochemical data, evaluated insulin resistance, body composition, malnutrition [by Malnutrition Inflammation Score (MIS)] and tested muscle function (by hand-grip strength, six-minute walking test and a questionnaire on fatigue).ResultsMstn levels were not significantly different between HD patients and controls (4.7 ± 2.8 vs 4.5 ± 1.3 ng/ml). In addition, while a decrease in Mstn was observed after HD treatment, there were no differences between BHD and HDF. In whole group of HD patients Mstn was positively correlated with muscle mass (r = 0.82, p < 0.001) and inversely correlated with age (r = − 0.63, p < 0.01) and MIS (r = − 0.39, p = 0.01). No correlations were found between Mstn and insulin resistance, such as between Mstn levels and parameters of muscle strength and fatigue. In multivariate analysis, Mstn resulted inversely correlated with fat body content (β = − 1.055, p = 0.002).ConclusionsCirculating Mstn is related to muscle mass and nutritional status in HD patients, suggesting that it may have a role in the regulation of skeletal muscle and metabolic processes. However, also considering the lack of difference of serum Mstn between healthy controls and HD patients and the absence of correlations with muscle function tests, our findings do not support the use of circulating Mstn as a biomarker of muscle wasting and malnutrition in HD.

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Section: Discussionsupporting

confidence: 84%

Significance of serum Myostatin in hemodialysis patients

Esposito¹,

Battaglia²,

Porta³

et al. 2019

BMC Nephrol

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“…It seems unclear how chronic hemodialysis (HD) and its method affect serum myostatin levels. Contrary to research by Koyun et al, presenting an elevated serum myostatin level in chronic hemodialysis patients compared to healthy controls [ 91 ], two other studies showed no difference between these groups [ 181 , 182 ]. Esposito et al, noticed a significant decrease of plasma myostatin (associated by the authors with improvement of malnutrition status) after online hemodiafiltration (HDF) with no changes after bicarbonate hemodialysis (BHD) [ 181 ], while further studies showed a significant and comparable decrease of plasma myostatin levels after HD and HDF, and HDF and BHD, accordingly [ 84 , 182 ].…”

Section: Factors Affecting Myostatin Concentrationmentioning

confidence: 62%

Myostatin as a Biomarker of Muscle Wasting and other Pathologies-State of the Art and Knowledge Gaps

2020

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Sarcopenia is a geriatric syndrome with a significant impact on older patients’ quality of life, morbidity and mortality. Despite the new available criteria, its early diagnosis remains difficult, highlighting the necessity of looking for a valid muscle wasting biomarker. Myostatin, a muscle mass negative regulator, is one of the potential candidates. The aim of this work is to point out various factors affecting the potential of myostatin as a biomarker of muscle wasting. Based on the literature review, we can say that recent studies produced conflicting results and revealed a number of potential confounding factors influencing their use in sarcopenia diagnosing. These factors include physiological variables (such as age, sex and physical activity) as well as a variety of disorders (including heart failure, metabolic syndrome, kidney failure and inflammatory diseases) and differences in laboratory measurement methodology. Our conclusion is that although myostatin alone might not prove to be a feasible biomarker, it could become an important part of a recently proposed panel of muscle wasting biomarkers. However, a thorough understanding of the interrelationship of these markers, as well as establishing a valid measurement methodology for myostatin and revising current research data in the light of new criteria of sarcopenia, is needed.

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“…This should explain why only weak RR were observed here, probably attributable to the predominant 40 kDa form of myoS present in the circulation. Interestingly, Esposito et al ., using the same ELISA kit (R&D Systems) could report decreased pre-dialysis levels of myoS after moving from a 3 month-HD period to a 3 month-HDF period but in only 10 patients 21 .…”

Section: Discussionmentioning

confidence: 99%

Randomised trial on clinical performances and biocompatibility of four high-flux hemodialyzers in two mode treatments: hemodialysis vs post dilution hemodiafiltration

Moréna

Créput

Bouzernidj

et al. 2019

Sci Rep

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This prospective multicenter randomized comparative cross-over trial aimed at evaluating the influence of hemodialysis vs post-dilution hemodiafiltration with high-flux dialyzers in solute clearance and biocompatibility profile. 32 patients were sequentially dialyzed with Leoceed-21HX, Polypure-22S+, Rexsys-27H and VIE-21A. Primary outcome was β2-microglobulin removal. Secondary outcomes were (i) extraction of other uremic solutes (ii) parameters of inflammation and nutrition and (iii) comparative quantification of perdialytic albumin losses (using total ‘TDC’ vs partial ‘PDC’ collection of dialysate). Significant increases in removal rates of β2-microglobulin (84.7 ± 0.8 vs 71.6 ± 0.8 mg/L), myoglobin (65.9 ± 1.3 vs 38.6 ± 1.3 µg/L), free immunoglobulin light chains Kappa (74.9 ± 0.8 vs 55.6 ± 0.8 mg/L), β-trace protein (54.8 ± 1.3 vs 26.8 ± 1.4 mg/L) and orosomucoid (11.0 ± 1.1 vs 6.0 ± 1.1 g/L) but not myostatin (14.8 ± 1.5 vs 13.0 ± 1.5 ng/mL) were observed in HDF compared to HD when pooling all dialyzers. Rexsys and VIE-A use in both HD and HDF subgroups was associated to a better removal of middle/large-size molecules compared to Leoceed and Polypure, except β2-microglobulin for Rexsys. Inflammatory parameters were unchanged between dialyzers without any interaction with dialysis modality. Mean dialysate albumin loss was comparable between TDC and PDC (1.855 vs 1.826 g/session for TDC and PDC respectively). In addition, a significant difference in albumin loss was observed between dialyzers with the highest value (4.5 g/session) observed using Rexsys. Use of all dialyzers was associated with good removals of the large spectrum of uremic toxins tested and good biocompatibility profiles, with an additional gain in removal performances with HDF. Larger surface area, thinner wall and resultant very high ultrafiltration coefficient of Rexsys should be taken into account in its clear performance advantages.

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Modulation of Myostatin/Hepatocyte Growth Factor Balance by Different Hemodialysis Modalities

Cited by 14 publications

References 25 publications

Significance of serum Myostatin in hemodialysis patients

Significance of serum Myostatin in hemodialysis patients

Myostatin as a Biomarker of Muscle Wasting and other Pathologies-State of the Art and Knowledge Gaps

Randomised trial on clinical performances and biocompatibility of four high-flux hemodialyzers in two mode treatments: hemodialysis vs post dilution hemodiafiltration

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