Response of Angiopoietin-like Proteins 3 and 4 to Hemodialysis

Mahmood, Dana; Makoveichuk, Elena; Nilsson, Solveig; Olivecrona, Gunilla; Stegmayr, Bernd

doi:10.5301/ijao.5000252

Cited by 13 publications

(17 citation statements)

References 30 publications

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“…In addition, there was no favourable outcome regarding lipid profile in the present short-term part of the study. This does not exclude a beneficial effect on the LPL system, since LPL is not extensively consumed during such dialysis [16].…”

Section: Discussionmentioning

confidence: 99%

Haemodialysis with Tinzaparin Versus Dialysate Citrate as Anticoagulation

Mahmood¹,

Stegmayr²

2018

Blood Purif

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Anticoagulation with citrate-containing haemodialysate (cHD) is an alternative to tinzaparin haemodialysate (tHD). The study investigated whether cHD would differ when changed from tHD. The same 18 patients were their own controls followed up with cHD for 5 months. LDL-cholesterol decreased at the end of a cHD session (p = 0.01). Neutrophils (p = 0.013) and monocytes (p = 0.007) dropped more during a cHD session. During the follow-up period of cHD, approximately 50% needed additional tinzaparin. Before the cHD session could start, there was a lower total cholesterol at 2 weeks (p = 0.014) and LDL-cholesterol at 1 month (p = 0.011) versus an increase of LDL at 5 months (p = 0.02). Only patients without additional tinzaparin had a reduction of C-reactive protein (CRP) at 2 months of cHD (p < 0.05) but not later. Solely cHD seems possible only in half of the patients. A greater reduction in granulocytes and monocytes during cHD indicates a more extensive blood membrane interaction, while CRP may be lower.

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Section: Discussionmentioning

confidence: 99%

Haemodialysis with Tinzaparin Versus Dialysate Citrate as Anticoagulation

Mahmood¹,

Stegmayr²

2018

Blood Purif

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“…A similar mechanism of inactivation has been proposed for ANGPTL3 [37]. It is notable that the plasma concentrations in HD patients are increased compared to ANGPTL4 [38,39] while there are conflicting results regarding ANGPTL3 with either increased [39] or reduced levels [40]. The reason for this difference is not clear.…”

Section: Introductionmentioning

confidence: 83%

“…One possibility is a different reactivity of the antibodies used and the complex pattern of molecular forms of the ANGPTLs in plasma. High flux HD, but not low flux, will reduce the level of ANGPTL4 but not ANGPTL3 in plasma [39]. …”

Section: Introductionmentioning

confidence: 99%

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Uremic Toxins and Lipases in Haemodialysis: A Process of Repeated Metabolic Starvation

Stegmayr

2014

Toxins

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Severe kidney disease results in retention of uremic toxins that inhibit key enzymes for lipid breakdown such as lipoprotein lipase (LPL) and hepatic lipase (HL). For patients in haemodialysis (HD) and peritoneal dialysis (PD) the LPL activity is only about half of that of age and gender matched controls. Angiopoietin, like protein 3 and 4, accumulate in the uremic patients. These factors, therefore, can be considered as uremic toxins. In animal experiments it has been shown that these factors inhibit the LPL activity. To avoid clotting of the dialysis circuit during HD, anticoagulation such as heparin or low molecular weight heparin are added to the patient. Such administration will cause a prompt release of the LPL and HL from its binding sites at the endothelial surface. The liver rapidly degrades the release plasma compound of LPL and HL. This results in a lack of enzyme to degrade triglycerides during the later part of the HD and for another 3–4 h. PD patients have a similar baseline level of lipases but are not exposed to the negative effect of anticoagulation.

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“…Some stored serum samples from subjects with insulin resistance and type 2 diabetes mellitus, participating in a previous study of effects of hyperinsulinemia on the levels of ANGPTL4, were used for comparison [24]. In addition we re-analyzed samples from a previous study of ANGPTL4 in patients on chronic hemodialysis (CHD) [25]. Pooled normal human serum was used for isolation of very low density lipoproteins (VLDL) by ultracentrifugation [26].…”

Section: Methodsmentioning

confidence: 99%

High Concentrations of Angiopoietin-Like Protein 4 Detected in Serum from Patients with Rheumatoid Arthritis Can Be Explained by Non-Specific Antibody Reactivity

et al. 2017

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Angiopoietin-like protein 4 (ANGPTL4) is suggested to be a master regulator of plasma triglyceride metabolism. Our aim was to study whether the previously reported high levels of ANGPTL4 detected in serum from patients with rheumatoid arthritis (RA) by ELISA was due to any specific molecular form of this protein (oligomers, monomers or fragments). ANGPTL4 levels were first determined in serum from 68 RA patients and 43 age and sex matched control subjects and the mean values differed by a factor of 5.0. Then, ANGPTL4 was analyzed after size exclusion chromatography (SEC) of serum samples. With serum from one of the RA patients with high levels of ANGPTL4, the dominant reactivity was found in fractions corresponding to high-molecular weight proteins. In addition, a minor peak of reactivity eluting late from the column was found both in the patient and in controls. By the use of HeteroBlock®, and by careful selection of antibodies, we documented non-specific reactions for ANGPTL4 in 39% of samples from the RA patients, most likely due to cross-reactivity of the antibodies with rheumatoid factor (RF). The corresponding figure for control subjects was 6.3%. After corrections for non-specific reactions, the mean level of ANGPTL4 in serum from RA patients was still significantly higher than in control individuals (mean levels were 101±62 and 67±39 ng/ml respectively, P = 0.02). We re-analyzed samples from our previously published studies on ANGPL4 levels in patients on hemodialysis and patients with diabetes type 2. These samples did not show false positive reactions. The levels of ANGPTL4 were comparable to those detected previously.

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Response of Angiopoietin-like Proteins 3 and 4 to Hemodialysis

Abstract: ANGPTL3 and ANGPTL4 were increased in HD patients. Anticoagulation with tinzaparin during cHD causes release of ANGPTL4 from tissues into blood. cHD using high-flux filters, to some extent, removed ANGPTL4. With citrate the levels of ANGPTL4 decreased.

Cited by 13 publications

References 30 publications

Haemodialysis with Tinzaparin Versus Dialysate Citrate as Anticoagulation

Haemodialysis with Tinzaparin Versus Dialysate Citrate as Anticoagulation

Uremic Toxins and Lipases in Haemodialysis: A Process of Repeated Metabolic Starvation

High Concentrations of Angiopoietin-Like Protein 4 Detected in Serum from Patients with Rheumatoid Arthritis Can Be Explained by Non-Specific Antibody Reactivity

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