engleski

The importance of GPI-anchored proteins in the ethiopathogenesis of the malnutrition, inflammation and atherosclerosis syndrome in chronic renal

The malnutrition-inflammation atherosclerosis syndrome occurs frequently in hemodialysis patients. It increases morbidity and mortality rates. The glycosylphosphatidylinositol (GPI)-anchored proteins in the cell membrane form lipid rafts. Disturbances in their distribution are basically responsible for the onset of a variety of diseases, including atherosclerosis. The goal of this study is to establish a link between GPI-anchored proteins and their ability of transport from cell to cell ( shedding and uptake ), and basic indicators of MIA syndrome in maintenance hemodialysis patients. This cross-sectional study involved 41 hemodialysis-treated patients (21 patients in whom renal failure was caused by diabetic nephropathy the DM group and 20 patients in whom renal failure was caused by some other causes the NDM) and 21 healthy subjects the C group. Clinical characteristics of the patients, serum levels of MIA syndrome biochemical markers, malnutrition-inflammation score (MIS) and anthropometric measurements were compared among the groups. The expression of GPI-anchored proteins (CD14, CD55, CD59 and CD87) on blood cells were measured with flow cytometry and compared among the groups before and after hemodialysis. The expression of individual GPI-anchored proteins differs among the groups. Quantitative changes occurring in the course of hemodialysis differ for each cell type. Comparison of mutual differences arising during hemodialyses for certain cell types revealed statistically significant differences in the extent of change, but also a uniform sequence of the extent of change in both groups of patients. Although the observed groups of patients do not differ in age, gender and anthropometric measurements, significant differences were found in the MIA syndrome biochemical markers. The studied GPI-anchored proteins did not show any group characteristics either in comparison with the observed laboratory and anthropometric features of this syndrome, or in comparison with hemodialysis treatment. Mutual comparisons of quantitative differences occurring during hemodialysis for individual cell types (with or without cell markers) revealed significant differences in the extent of the change, which may be an indication of the occurrence of shedding and uptake of GPI-anchored proteins.The destiny of GPI-anchored proteins largely depends on the structure of their protein part which determines their functional characteristics and on the type of the host cells, whereas the lipid raft is only a part of their structure.

hemodialysis ; chronic renal failure ; malnutrition ; inflammation ; atherosclerosis ; GPI-anchored proteins

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