Interference of angiotensin-converting enzyme inhibitors on erythropoiesis in kidney transplant recipients - Role of growth factors and cytokines
Interference of angiotensin-converting enzyme inhibitors on erythropoiesis in kidney transplant recipients - Role of growth factors and cytokines
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DOI：
10.1097/00007890-199709270-00021
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发表时间：
1997-09-27
期刊：
影响因子：
6.2
通讯作者：
Schena, FP
中科院分区：
文献类型：
--
作者：
Morrone, LF;DiPaolo, S;Schena, FP
背景。最近的数据表明，促红细胞生成素（EPO）以外的因子，例如胰岛素样生长因子1（IGF-1），可以在体外促进红细胞生成并纠正体内慢性肾功能衰竭的贫血，IGF-1是在生长激素控制下由肝脏产生的，也可以由包括肾脏在内的其他来源产生。生长因子和细胞因子的促红细胞生成作用及其可能受到血管紧张素转换酶抑制剂（ACEI）的调节已探索出方法。本研究评估了 40 名伴或不伴移植后红细胞增多症 (PTE) 的肾移植患者和 10 名活体肾捐献者的 EPO、IGF-1、白细胞介素 (IL)-2、IL-3 和粒细胞巨噬细胞集落刺激因子的血清水平。然后，在 PTE 患者中检查 ACEI 治疗对上述模式的影响。结果。患有 PTE 的患者的 EPO 和 IGF-1 血清水平显着高于无 PTE 的患者和活体肾供者受试者，ACEI 治疗显着降低了血细胞比容 (Hct) 以及循环 IGF-1 和 EPO 水平。值得注意的是，IGF-1 的降低主要在那些 EPO 水平未通过 ACEI 治疗显着改变的患者中显着。在所有患者中，Hct 水平与循环 IGF-1 水平有直接关系，但与 EPO 浓度无关。生长激素在各检查组之间没有显着差异，而在ACEI治疗下则急剧增加。最后，检测到IL-2、IL-3和粒细胞巨噬细胞集落刺激因子血清水平没有显着差异。结论。 IGF-1 似乎在 PTE 患者中与 ACEI 相关的 Hct 降低中发挥作用，主要是在 EPO 血清水平没有任何改变的患者中。
Background. Recent data indicate that factors other than erythropoietin (EPO), such as insulin-like growth factor 1 (IGF-1), can promote erythropoiesis in vitro and correct the anemia of chronic renal failure in vivo, IGF-1 is produced by the liver under growth hormone control, as well as by other sources, including the kidney, The erythropoietic role of growth factors and cytokines and their possible modulation by angiotensin-converting enzyme inhibitors (ACEI) has never been explored.Methods. This study evaluated;the serum levels of EPO, IGF-1, interleukin (IL)-2, IL-3, and granulocyte macrophage-colony-stimulating factor in 40 kidney transplanted patients with or without posttransplant erythrocytosis (PTE) and in 10 living kidney donors. Then, the effect of ACEI therapy on the above pattern was examined in patients with PTE.Results. EPO and IGF-1 serum levels were significantly higher in patients with PTE than in patients without PTE and in living kidney donor subjects, ACEI therapy significantly reduced hematocrit (Hct) as well as circulating IGF-1 and EPO levels, Of note, the decrease in IGF-1 was prominent mainly in those patients whose EPO levels were not significantly modified by ACEI therapy, In all of the patients Hct levels displayed a direct relationship with circulating IGF-1 levels, but not with EPO concentration. Growth hormone did not significantly differ among the groups examined, whereas it steeply increased under ACEI, Finally, no significant difference in IL-2, IL-3, and granulocyte macrophage-colony-stimulating factor serum levels was detected.Conclusions. IGF-1 seems to play a role in the ACEI-related decrease of Hct in patients with PTE, chiefly in patients without any modification of EPO serum levels.