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Positive association between plasma levels of oxidized low‐density lipoprotein and myeloperoxidase after hemodialysis in patients with diabetic end‐stage renal disease
Authors:Chizuko Kitabayashi  Takahiko Naruko  Kenichi Sugioka  Kei Yunoki  Masashi Nakagawa  Mayumi Inaba  Masahiko Ohsawa  Yoshio Konishi  Masahito Imanishi  Takeshi Inoue  Hiroyuki Itabe  Minoru Yoshiyama  Kazuo Haze  Anton E Becker  Makiko Ueda
Affiliation:1. Department of Pathology, Osaka City University Graduate School of Medicine, , Tokyo, Japan;2. Department of Cardiology, Osaka City General Hospital, , Tokyo, Japan;3. Department of Internal Medicine and Cardiology, Osaka City University Graduate School of Medicine, , Tokyo, Japan;4. Department of Surgical Pathology, Osaka City University Graduate School of Medicine, , Tokyo, Japan;5. Division of Nephrology and Hypertension, Osaka City General Hospital, , Tokyo, Japan;6. Department of Pathology, Osaka City General Hospital, , Tokyo, Japan;7. Department of Biological Chemistry, School of Pharmaceutical Sciences, Showa University, , Tokyo, Japan;8. Academic Medical Center, University of Amsterdam, , Amsterdam, The Netherlands
Abstract:End‐stage renal disease (ESRD) patients undergoing hemodialysis (HD) have a high prevalence of cardiovascular events. Low‐density lipoprotein (LDL) in dialysis patients has been shown to be susceptible to in vitro peroxidation; therefore, oxidized‐LDL (ox‐LDL) could be generated in these patients. Moreover, myeloperoxidase (MPO) released from activated neutrophils may play a role in the induction of LDL oxidation. The purpose of this study was to investigate the relationship between plasma ox‐LDL levels, plasma MPO levels, and serum high‐sensitivity C‐reactive protein (hs‐CRP) levels during initial HD in patients with diabetic ESRD. Patients (n = 28) had serial venous blood samples drawn before and after HD at the initial, second, and third sessions. Plasma ox‐LDL levels were measured using a specific monoclonal antibody (DLH3), and plasma MPO levels were measured using an enzyme‐linked immunosorbent assay kit. Plasma ox‐LDL levels and MPO levels after a single HD session increased significantly (ox‐LDL, P < 0.005; MPO, P < 0.0001) compared with levels before that HD session. However, the increase was transient since the levels returned to pre‐HD session levels. Additionally, plasma MPO levels showed a positive correlation with plasma ox‐LDL levels during HD (R = 0.62, P = 0.0029). No significant change was observed in serum hs‐CRP levels before and after each HD session. This study demonstrates that plasma MPO levels are directly associated with plasma ox‐LDL levels in diabetic ESRD patients during initial HD. These findings suggest a pivotal role for MPO and ox‐LDL in the progression and acceleration of atherosclerosis in patients undergoing HD.
Keywords:end‐stage renal disease  oxidative stress  atherosclerosis  inflammation
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