Serum Alpha-1-Antitrypsin in Hemodialysis Patients with Dialysis Arthropathy

Docci, D; Bilancioni, R; Baldrati, L; C, Capponcini; Delvecchio, C; Feletti, C

doi:10.1177/039139889301600303

Cited by 4 publications

(2 citation statements)

References 16 publications

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“…No effect of either disease or dialysis was seen in these patients. Similar results have been reported by Docci et al [4] who reported lower mean serum alpha-1 AT in 23 uncomplicated haemodialysis patients. Group B had 20% patients in whom a normal predialysis level culminated into an elevated abnormal level.…”

Section: Discussionsupporting

confidence: 90%

Study of Acute Phase Response in Patients With Chronic Renal Failure on Haemodialysis

Ayyagari¹,

Byram²

2016

jemds

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In recent times, significant attention has been paid to the study of acute phase reactants in patients with Chronic Renal Failure (CRF) undergoing haemodialysis. Alpha-1 antitrypsin is a proteinase inhibitor and represents a defense mechanism to protect the tissues from proteolytic enzyme activity. In CRF, the leucocyte function appears to be impaired because of coexisting acidosis, hyperglycaemia, and azotaemia. However, dialysis membranes can induce neutrophil activation, which can be studied by the nitroblue tetrazolium test. AIMS AND OBJECTIVESTo study the serum alpha-1 antitrypsin levels in patients of CRF on long-term dialysis at different intervals (before, immediately after, and 8 hours after dialysis) and to appreciate and establish the extent of neutrophil activation in CRF patients by the nitroblue tetrazolium test. MATERIALS AND METHODThe present study was a prospective one carried out in the Departments of Pathology and Nephrology at Osmania Medical College and Osmania General Hospital over a period of two and a half years. A total of 50 patients with chronic renal failure who were on regular haemodialysis were selected for the study. Serum alpha-1 antitrypsin levels were studied in three samples, predialysis, immediately after dialysis, and 8 hours after dialysis by using a spectrophotometer. The nitroblue tetrazolium test was done in 25 patients in fresh EDTA anticoagulated blood smears stained by nitroblue tetrazolium and neutrophils containing black formazan pigment were considered to be NBT positive. RESULTSThe serum levels of alpha-1 AT of CRF patients was taken as a whole and compared to that of control. The results were also compared according to the time bound frequency and some trends were observed, which were grouped into four types.Group A-This group exhibited almost a normal level of serum levels of alpha-1 AT throughout (before, immediately after, and 8 hours after dialysis). Group B-This group showed an initial normal level to an abnormal final level. Group C-This group showed an initial abnormal level and a normal postdialysis level. Group D-This group maintained an abnormal level throughout. For the NBT reduction test, an increase after dialysis was noted in all the four groups with a significant increase in B and D groups. CONCLUSIONSA general phenomenon of acute phase response with raised serum alpha-1 AT and raised NBT positivity is seen in CRF patients. Underlying diseases along with their biochemical and metabolic abnormalities have a role in acute phase reaction. Dialysis procedure also seems to have a role in inducing persistent acute phase reaction in a small population of CRF patients and one has to be watchful for sequelae of adverse reactions thereof in such patients.

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Section: Discussionsupporting

confidence: 90%

Study of Acute Phase Response in Patients With Chronic Renal Failure on Haemodialysis

Ayyagari¹,

Byram²

2016

jemds

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“…In the present study, reagent‐grade bovine fibrinogen and thrombin were purchased commercially and combined with ovine fibronectin and vitronectin extracts isolated by preparative affinity chromatography. This single‐step enrichment increases fibronectin and vitronectin concentrations approximately 10‐fold relative to serum, but substantial amounts of other, uncharacterized serum proteins are also present in the concentrates and may contribute beneficial anti‐protease and mitogenic effects20, 21. For example, the improved hydrogel integrity observed in samples containing these extracts is likely due to anti‐proteases, such as α‐2 macroglobulin, and residual serum transglutaminase within the glycoprotein extracts, and not to any direct effects of either fibronectin or vitronectin on crosslinking or degradation.…”

Section: Discussionmentioning

confidence: 99%

Design and testing of biological scaffolds for delivering reparative cells to target sites in the lung

Ingenito

Şen

Tsai

et al. 2009

J Tissue Eng Regen Med

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This study summarizes the development and testing of a scaffold to promote engraftment of cells in the distal lung. A fibrinogen-fibronectin-vitronectin hydrogel (FFVH) was developed and optimized with respect to its mechanical and biological properties for this application. In vitro, FFVH scaffolds promoted attachment, histiotypic growth and expression of basement membrane proteins by primary ovine lung mesenchymal cells derived from lung biopsies. In vivo testing was then performed to assess the ability of FFVHs to promote cell engraftment in the sheep lung. Treatment with autologous cells delivered using FFVH was clinically well tolerated. Cells labelled with a fluorescent dye (PKH-26) were detected at treatment sites after 1 month. Tissue mass (assessed by CT imaging) and lung perfusion (assessed by nuclear scintigraphy) were increased at emphysema test sites. Post-treatment histology demonstrated cell proliferation and increased elastin expression without scarring or collapse. No treatment-related pathology was observed at healthy control sites. FFVH scaffolds promote cell attachment, spreading and extracellular matrix expression in vitro and apparent engraftment in vivo, with evidence of trophic effects on the surrounding tissue. Scaffolds of this type may contribute to the development of cell-based therapies for patients with end-stage pulmonary diseases.

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Beta 2 microglobulin isoforms in healthy individuals and in amyloid deposits

Argilés

Garcia-Garcia

Derancourt

et al. 1995

Kidney International

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beta 2 microglobulin (beta 2m) is classically known to have isoforms with isoelectric points (pI) 5.7 and 5.3. New isoforms of beta 2m with lower pI, probably due to modifications with advanced glycation end products, were found in the amyloid deposits of dialysis related amyloidosis (DRA), and they were proposed as the amyloidogenic forms of beta 2m. The other modifications in beta 2m from amyloid deposits are partial proteolysis and single amino acid replacement (Asn by ASp at position 17). However, there are no data on the sequence of the different isoforms of beta 2 m from amyloid deposits. Amyloid deposits surgically obtained from the carpal tunnel from 13 dialysis treated patients and urine from 10 healthy volunteers and 5 living-related kidney donors were analyzed for beta 2m content. Two-dimensional gel electrophoresis (2D-PAGE) of beta 2m from amyloid deposits showed the presence of four or more isoforms with pIs < 5.7. All the spots migrating at 12 kDa Mr region and between 4 and 6 pH reacted with rabbit anti-human beta 2m antibody by Western blotting, confirming that they were beta 2m isoforms. beta 2m isoforms from the amyloid deposits were then separately purified with an IEF column (PB94, Pharmacia) for analysis. Enough quantities of three pure beta 2m isoforms could be obtained in two cases. The sequence analysis showed an intact N-terminus in all the isoforms. There was Asn in the 17th residue in all the isoforms sequenced. 2D-PAGE of urine from 8 out of the 10 healthy volunteers showed the presence of beta 2m. In two of them beta 2m also displayed four different isoforms. At least four isoforms were observed in urine of all the kidney donors. The present study shows that the elution peaks of three different beta 2m isoforms in gel isoelectrofocusing contain beta 2m with intact N-terminus. None of them have deamidated their 17th residue. More importantly, the beta 2m isoforms with lower pI are not specific for amyloidosis as they were found in urine from kidney donors and in normal volunteers. These results bring into question the hypothesis that dialysis related amyloidosis is due to the known modifications on beta 2m. They suggest that the precipitation of beta 2m into amyloid fibrils should result from the interaction of beta 2m with other factors with amyloid enhancing activity.

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Serum Alpha-1-Antitrypsin in Hemodialysis Patients with Dialysis Arthropathy

Cited by 4 publications

References 16 publications

Study of Acute Phase Response in Patients With Chronic Renal Failure on Haemodialysis

Study of Acute Phase Response in Patients With Chronic Renal Failure on Haemodialysis

Design and testing of biological scaffolds for delivering reparative cells to target sites in the lung

Beta 2 microglobulin isoforms in healthy individuals and in amyloid deposits

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