Effect of methoxy polyethylene glycol-epoetin beta on oxidative stress in predialysis patients with chronic kidney disease

Abstract

BackgroundThere is data in the literature indicating increased oxidative stress in chronic kidney disease (CKD). Erythropoiesis-stimulating agents (ESAs), which are commonly used to treat anemia in patients with CKD, seem to have an antioxidant action, which could be a part of nephroprotection. The aim of the current study was to investigate the effect of a long half-life ESA, methoxy polyethylene glycol-epoetin beta (Mircera), on some markers of oxidative stress in predialysis patients with CKD.Material/MethodsPeripheral blood was collected from 28 predialysis CKD patients 2 times, before Mircera treatment and after achieving target hemoglobin (Hb), and 15 healthy subjects (control group). Superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), and catalase (CAT) activity in erythrocytes were measured according to commonly used methods as a function of the antioxidant defense system. To assess reactive oxygen species (ROS) production, malondialdehyde (MDA) concentration in erythrocytes and in plasma was measured according to a commonly used method.ResultsSOD, GSH-Px, and CAT activity were similar, but plasma and erythrocyte MDA concentrations were significantly higher in CKD patients before ESA treatment in comparison to the control group. SOD, GSH-Px, and CAT activity was significantly higher, but plasma and erythrocyte MDA concentrations were significantly lower, in CKD patients after ESA treatment in comparison to these patients before treatment. We did not find a significant correlation between Hb concentration and SOD, GSH-Px, and CAT activity and plasma, as well as erythrocyte MDA concentrations. Analysis of all investigated groups showed a significant negative correlation between Hb concentration and plasma MDA concentration.ConclusionsOur results suggest that treatment of anemia with methoxy polyethylene glycol-epoetin beta may inhibit oxidative stress in predialysis patients with CKD by enhancing the antioxidant defense system and reducing ROS production.

Oxidative stress and labile plasmatic iron in anemic patients following blood therapy

“…These data are extremely important to avoid misinterpretations, as it was previously shown that any imbalance between α and β chains of hemoglobin (α or β-thalassemia, respectively) plays a crucial role in OS [27] . Besides, there are data linking the observed levels of the various biomarkers evaluated in this study to health outcomes, such as in renal failure [28] and breast cancer [29] . Taking into account our results and those previously found, it is plausible to assume that under blood transfusion therapy, the excess of labile (catalytically active) iron must generate free radicals via Fenton chemistry, resulting in oxidative damage to biomolecules in vivo [30] .…”

Pleiotropic and Renoprotective Effects of Erythropoietin Beta on Experimental Diabetic Nephropathy Model

“…Oxidative stress can result in mitochondrial injury, nutritional impairment, and DNA damage in diabetic patients [15,16]. Bartnicki et al [17 ]showed that methoxy polyethylene glycol-epoetin beta improves systemic oxidative stress in predialysis chronic kidney disease patients. Dang et al [18] demonstrated that epoetin beta prevents reactive oxygen species generation and prevent high glucose-induced renal cell apoptosis in diabetic kidney.…”

“…A search of the literature shows that recombinant human erythropoietin and its synthetic derivatives (at least epoetin beta and methoxy polyethylene glycol-epoetin beta) have anti-oxidant, anti-inflammatory and cytoprotective properties [17,18,19,22,23,24,25]. But it cannot be concluded that different synthetic derivatives of epoetin may offer the same effects on cytoprotection, possibly a result that may reflect different affinities binding to the EPOR.…”

Association between Serum Fructosamine and Kidney Function in Nondiabetic Individuals without Chronic Kidney Disease

“…Earlier investigations clearly showed that oxidative stress and inflammatory factors were links between CKD and cardiovascular complications [ 13 , 14 ]. Very recently, some studies found that methoxy polyethylene glycol-epoetin beta may inhibit oxidative stress through enhancing the antioxidant defense system and reducing reactive oxygen species (ROS) in predialysis patients with CKD [ 15 ], Yimaz MI and Xu G et al [ 16 , 17 ] reported that estimated GFR was negatively associated with malondialdehyde concentration and positively correlated with ROC activity, and that oxidative stress and inflammation alter GFR when CKD develops, which could indicate that oxidative stress and inflammation in the body cause decreased GFR.…”