Scavenger Receptor Expression in Monocyte-macrophages and Accumulation of Oxidized LDL in Dialysis Patients

目的：阐明透析患者动脉粥样硬化的发病机制。研究了透析患者和健康对照组单核巨噬细胞SR的表达，制备了抗氧化型低密度脂蛋白抗体，并检测了4例血液透析患者和4例年龄、性别匹配的对照组SR mRNA的表达。体外培养7d后，单核细胞分化为巨噬细胞，逆转录-聚合酶链式反应分析SRI型和II型mRNA的表达，并用Southern杂交的辐射密度进行定量。用抗氧化型低密度脂蛋白抗体酶联免疫吸附试验检测尿毒症血液透析(HD)患者的血浆脂质过氧化反应。结果表明，与对照组相比，尿毒症患者在分化过程中仅SR-I表达增加，且在分化后1~2天加速表达，5天后增强。患者血浆氧化低密度脂蛋白水平显著升高，为54.4±12.5微克/毫升，而正常对照组为28.1±8.4微克/毫升。动脉硬化闭塞组(ASO)患者血浆氧化低密度脂蛋白和PCOOH水平显著高于非动脉硬化闭塞组，而总胆固醇、甘油三酯和低密度脂蛋白水平无显著差异。结论：透析患者巨噬细胞氧化低密度脂蛋白受体表达增强，可能与I型上调有关，可能参与了动脉粥样硬化的发生。

To elucidate the machanism of atherosclerosis in dialysis patients. SR expression was studied in monocyte-macrophages from dialysis patents and healthy controls, and anti-oxidized LDL antibody was developed.SR mRNA expression was examined in four hemodialysis patients and four controls matched for age and sex. Monocytes were allowed to differentiate into macrophages in in vitro cultures for seven days and SR type I and II mRNA expression were analyzed with the reverse transcription-polymerase chain reaction and quantitated using radiation densities of Southern blots. Only SR type I expression increased during differentiation and was accelerated by one or two days and enhanced after five days in patients, as compared to controlsPlasma lipid peroxidation in uremic patients undergoing hemodialysis (HD) by means of a ELISA method using anti-oxidized LDL antibody. Plasma oxidized LDL levels were significantly elevated 54.4<plus-minus>12.5mug/ml in the patients, while being 28.1<plus-minus>8.4mug/ml in normal controls. Plasma oxidized LDL and PCOOH levels of the subjects associated with arteriosclerosis obliterance (ASO) were significantly higher than that of patients without ASO.In the total cholesterol, trigyceride, and LDL-lipoprotein, there were no significant between the patients with and withoutIn conclusion, oxidized LDL SR expression is enhanced in macrophages from dialysis patients, probably by up-regulation of type I.which may contribute to the development of atherosclerosis in these patients.