Immunogenicity of advanced glycation end products in diabetic patients and in nephropathic non-diabetic patients on hemodialysis or after renal transplantation
Autor: | Sandro Mazzaferro, E. Sagratella, Susanna Morano, Rosalba Cipriani, M. Sensi, A. M. Buongiorno, S. Morelli |
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Předmět: |
Adult
Glycation End Products Advanced Male medicine.medical_specialty Time Factors Advanced glycation end products (AGE) diabetic nephropathy diabetes Endocrinology Diabetes and Metabolism medicine.medical_treatment Urology Renal function Glomerulonephritis Membranous Diabetes mellitus genetics Endocrinology Glycation Renal Dialysis Diabetes mellitus Diabetes Mellitus Medicine Humans Kidney transplantation Aged business.industry Immunogenicity Middle Aged medicine.disease Kidney Transplantation Surgery Transplantation Kidney Failure Chronic Female Hemodialysis business |
Zdroj: | ResearcherID Scopus-Elsevier |
Popis: | Advanced glycation end products (AGE) increase as a consequence of diabetic hyperglycemia and, in nephropathic patients, following renal function loss. Protein-bound AGE behave as immunogens, inducing formation of specific antibodies (Ab-AGE). In this work AGE immunogenicity was studied in 42 diabetic patients, 26 nephropathic patients on hemodialysis and 26 patients with end-stage renal disease who underwent kidney transplantation and in 20 normal subjects. Non-oxidation-derived AGE (nox-AGE), oxidation-derived AGE (ox-AGE) and Ab-AGE were measured by competitive or direct enzyme-linked immunosorbent assay (ELISA) and circulating immune complexes (CIC) by C1q ELISA. Nox- AGE increased significantly in all patient groups (p < or = 0.05 to < or = 0.0001) except in patients on hemodialysis for less than 6 yr. Ox-AGE were only significantly increased in patients transplanted more than 3 yr previously (p < 0.05). Ab-AGE were significantly lower than controls in both diabetic groups and in patients on hemodialysis for more than 6 yr (p < 0.005 to < 0.0001) and not unlike controls in the other groups. These results demonstrate that hemodialysis or renal transplantation can, initially, reduce either nox- or ox-AGE levels, which however go back to being high in time. Renal transplantation fails to normalize nox-AGE. More importantly, plasma Ab-AGE levels are reduced or unchanged in all patient groups in comparison with controls, despite higher circulating AGE levels. This suggests the importance of tissue-bound AGE as Ab-AGE targets. Additional interventions are needed to control AGE levels in treated nephropathic patients. The search and quantification of specific Ab-AGE would give more meaningful results if performed over specific tissue specimens. |
Databáze: | OpenAIRE |
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