不同方式血液透析对维持透析病人巨噬细胞ATP结合盒受体-1水平的影响

Influences of different blood purification treatments on the expression of ABCA1 in patients with maintenance dialysis

摘要:

目的：探讨不同方式血液透析对维持透析病人巨噬细胞ATP结合盒受体-１表达水平的影响。方法：2010年8月至2012年3月，选取重庆医科大学第一附属医院长期规律透析的慢性肾衰患者60例，按不同血液净化方式分为2组：普通血液透析（hemodialysis，HD）组、血液透析滤过（hemodiafiltration，HDF）组，每组30例，同时选取健康体检者20例为对照组。分离外周血单核细胞诱导贴壁巨噬化，油红O染色鉴定为巨噬细胞，应用 real-time PCR与Western blot方法测定细胞ATP结合盒受体 A1（ATP-binding cassette receptor A1，ABCA1）、核转录因子-κB（nuclear factor-κB，NF-κB）的 mRNA及蛋白表达。结果：HD、HDF ２组患者巨噬细胞中ABCA1 mRNA与蛋白表达显著低于对照组（P<0.01），并且HDF组患者巨噬细胞ABCA1 mRNA与蛋白表达高于HD组（P<0.05）。HD、HDF 2组患者 NF-κB mRNA与蛋白表达高于对照组（P<0.01，P<0.05），HDF组较HD组 NF-κB mRNA与蛋白表达明显降低（P<0.01）。结论：维持透析患者巨噬细胞的胆固醇外流功能明显降低，这种下调与透析病人NF-κB的表达增加有关，透析滤过可以增加透析病人ABCA1的表达。

Abstract:

Objective：To evaluate influences of different blood purification treatments on expressions of ATP-binding cassette receptor A1（ABCA1） in patients with maintenance dialysis. Methods：Between August 2010 and March 2012，30 uremia patients treated by hemodialysis（HD），30 uremia patients treated by hemodiafiltration（HDF） and 20 healthy volunteers（control group） were investigated. Peripheral blood mononuclear cells were isolated and stimulated to transfer to macrophages. Macrophages were identified by Oil red O dyeing. Macrophages were collected to detect ABCA1 and nuclear factor-κB p65（NF-κB p65）expression by using real-time PCR and Western blot. Results：Expression of ABCA1 was significantly decreased in HD and HDF groups compared with that in control group（P<0.01）. Expression of ABCA1 was increased in HDF group compared with that in HD group（P<0.05）. Furthermore，expression of NF-κBp65 mRNA and protein in HD and HDF groups was higher than that in control group（P<0.01，P<0.05）. Expression of NF-κBp65 mRNA and protein in HDF group was significantly lower than that in HD group（P<0.01）. Conclusions：HDF may increase cholesterol efflux in human monocyte-macrophage derived foam cells，the mechanism of which may associate with inactivation of NF-κBp65 pathway and increase of the expression of ABCA1 mRNA and protein.