Assessment of Myeloperoxidase and Oxidative α1-Antitrypsin in Patients on Hemodialysis

Abstract

Background and objectives: The present study assesses the effects of the oxidative stress marker, myeloperoxidase (MPO), and the possible MPO-related oxidative stress marker, oxidative ␣ 1 -antitrypsin (oxAT), on carotid intima-media thickness (CIMT) and protein-energy wasting (PEW) in patients on hemodialysis (HD).Design, setting, participants, & measurements: Blood samples were obtained from 383 patients before HD to measure WBC count, serum albumin, lipids, high-sensitivity C-reactive protein (CRP), ␣ 1 -antitrypsin (AT), interleukin-6, oxidative LDL-C, MPO, and oxAT. We assessed both CIMT and the geriatric nutritional risk index (GNRI) in this cross-sectional competitive study.Results: Levels of MPO and oxAT correlated. Myeloperoxidase was associated with max-CIMT, and oxAT correlated with max-CIMT and GNRI. Multivariate linear regression models showed that MPO and oxAT were independent predictors of increasing max-CIMT, whereas oxAT, but not MPO, independently correlated with GNRI. In four combined MPO and oxAT groups classified according to median values, a multinomial logistic regression model showed that high MPO together with high oxAT was independently associated with increased max-CIMT. Moreover, the OR for max-CIMT with positive PEW and high MPO was significantly increased in the four groups with combined MPO and PEW.Conclusions: High MPO with high oxAT and high MPO with PEW seem to contribute to plaque formation in patients on HD, whereas elevated MPO or oxAT alone might not predict increasing CIMT. In contrast, a high oxAT value seems to be an independent predictor of PEW in patients on HD.

Oxidized High-Density Lipoprotein Is Associated with Protein-Energy Wasting in Maintenance Hemodialysis Patients

“…On the other hand, a study confirming the association between nutritional state and oxidative stress demonstrated aggravated oxidative stress in PEW patients with low BMI (21). Moreover, levels of oxidized ␣1-antitrypsin, a potential marker of activated neutrophil-associated oxidation includ- ing MPO-catalyzed hypochlorous acid production, seems to be increased in MHD patients with low BMI levels and associated with decreases in GNRI (22). oxHDL may therefore not always be increased in patients with increased fat mass with concomitant oxidative stress but could appear in MHD patients with low BMI and decreased fat.…”

Melatonin is a potent modulator of antioxidative defense and cellular proliferation against aluminum toxicity in rats

“…Krudeiner and Verspaget (2002) showed that oxidative stress occurs with the abundance of free radicals created by leucocytes in the inflammation of intestines, thereby the damage in the inflammatory region progresses. In our study, the MPO values were determined, which are both a measure of inflammation (Loria et al, 2008) and an indicator of oxidative stress with their prooxidant property (Honda et al, 2009). The increase in MPO values in the aluminum group is indicative of the fact that Al might produce free radicals in the small intestine and, therefore, cause oxidative stress and inflammation in the tissues.…”

Assessment of Inflow of Endotoxin and Its Fragments in Patients on Maintenance Hemodialysis

“…2). Therefore, obviously increased EA levels in these patients might be a risk factor for PEW as a consequence of chronic inflammation and oxidative stress [35,36]. …”