Changes in microparticle profiles by vitamin D receptor activation in chronic kidney disease – a randomized trial

BMC Nephrology

卷:20

Jonas Spaak¹  Kristina Lundwall¹  Fariborz Mobarrez²  Gun Jörneskog²  Stefan H. Jacobson³  Josefin Mörtberg³ 

[1] Department of Cardiology, Danderyd University Hospital;

[2] Department of Medicine, Danderyd University Hospital;

[3] Department of Nephrology, Danderyd University Hospital;

关键词: Microparticles;    ICAM-1;    Endothelial function;    Vitamin D;    Chronic kidney disease;   

DOI  :  10.1186/s12882-019-1445-4

来源: DOAJ

【 摘 要 】

Abstract Background Microparticles (MPs) are biomarkers and mediators of disease through their expression of surface receptors, reflecting activation or stress in their parent cells. Endothelial markers, ICAM-1 and VCAM-1, are implicated in atherosclerosis and associated with cardiovascular risk. Chronic kidney disease (CKD) patients have endothelial dysfunction and high levels of endothelial derived MPs. Vitamin D treatment has been reported to ameliorate endothelial function in CKD patients. We aimed to examine cell specific MP profiles and concentrations of MPs expressing the atherosclerotic markers ICAM-1 and VCAM-1 after treatment with paricalcitol in patients with CKD stage 3–4. Methods Sub-study of the previously reported SOLID trial where 36 patients were randomly assigned to placebo, 1 or 2 μg paricalcitol, for 12 weeks. MPs were measured by flow cytometry after labelling with antibodies against endothelial (CD62E), platelet (CD62P, CD41, CD154) leukocyte (CD45) and vascular (CD54, CD106) markers. Results Patients had a mean age of 65 years with a mean eGFR of 40 mL/min/1.73m2. Concentrations of ICAM-1 positive MPs were significantly reduced by treatment (repeated measures ANOVA p = 0.04). Repeated measures MANOVA of concentrations of endothelial, platelet and leukocyte MPs showed sustained levels in the 2 μg treatment group (p = 0.85) but a decline in the 1 μg (p = 0.04) and placebo groups (p = 0.005). Conclusions Treatment with paricalcitol reduces concentrations of ICAM-1 positive MPs. This is accompanied by sustained concentrations of all cell specific MPs in the 2 μg group, and decreasing concentrations in the other groups, possibly due to a more healthy and reactive endothelium with paricalcitol treatment.

【 授权许可】

Unknown