ABSTRACT
Recently, involvement of remnant-like particle cholesterol (RLP-C) in atherosclerosis was reported, but this parameter has not been adequately investigated in hemodialysis (HD) patients. The present study investigated the relationship between the RLP-C level and total cholesterol (TC), triglycerides (TG), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), lipid peroxides (malone dialdehyde, MDA), apolipoprotein (Apo) A-I, and ApoB. In addition, the fractions of very low density lipoprotein (VLDL), intermediate density lipoprotein (IDL), LDL, and HDL in serum lipoproteins were determined by disk polyacrylamide gel electrophoresis. The relationship between the RLP-C level and three atherogenic indices was also studied. The RLP-C level in HD patients (8.2 +/- 6.7 mg/dl) was significantly higher than that in normal controls (2.7 +/- 1.3 mg/dl). The RLP-C level showed a significant positive correlation with the levels of TC, TG, LDL-C, MDA, ApoB, VLDL(%), and IDL(%), as well as a negative correlation with HDL(%). However, there was no correlation with age or the duration of HD. RLP-C also showed significant positive correlations with the (TC -HDL-C)/HDL-C ratio and the (VLDL + LDL)/HDL ratio, as well as a negative correlation with the ApoA-I/ApoB ratio. These results suggest that RLP-C may be a potential indicator of atherogenic risk in HD patients.
Subject(s)
Arteriosclerosis/epidemiology , Cholesterol/chemistry , Chylomicrons/blood , Kidney Failure, Chronic/complications , Renal Dialysis , Adult , Aged , Arteriosclerosis/blood , Arteriosclerosis/complications , Cholesterol/blood , Fasting , Female , Humans , Kidney Failure, Chronic/blood , Kidney Failure, Chronic/therapy , Lipids/blood , Male , Middle Aged , Risk Factors , Sex DistributionSubject(s)
Glomerulonephritis, IGA/complications , Neurofibromatosis 1/complications , Adult , Chromosome Aberrations , Chromosome Disorders , Chromosomes, Human, Pair 17 , Female , Glomerulonephritis, IGA/diagnosis , Glomerulonephritis, IGA/genetics , HLA Antigens/analysis , Histocompatibility Testing , Humans , Male , Neurofibromatosis 1/diagnosis , Neurofibromatosis 1/genetics , Nuclear FamilyABSTRACT
We report on a 22-year-old female with focal glomerular sclerosis and hyperlipidemia who did not respond to long-term steroid or immunosuppressant therapy. When low-density lipoprotein (LDL) apheresis was performed, her total daily protein excretion decreased, serum albumin increased, total cholesterol decreased from 1,052 mg/dl to 148 mg/dl after 3 months, and the serum lipoprotein(a) level also decreased from 117.8 mg/dl to 9.1 mg/dl. After this therapy, her clinical course was well maintained. By controlling hyperlipidemia, including oxidized low-density lipoprotein and lipoprotein(a), low-density lipoprotein apheresis may produce clinical improvement in focal glomerular sclerosis.
Subject(s)
Glomerulosclerosis, Focal Segmental/therapy , Lipoproteins, LDL/isolation & purification , Plasmapheresis , Adult , Creatinine/blood , Female , Glomerulosclerosis, Focal Segmental/blood , Humans , Lipoproteins, LDL/bloodABSTRACT
To investigate the involvement of bacterial antigens in Immunoglobulin A (IgA) nephropathy, we measured IgA, IgG and IgM antibodies to gram-negative Escherichia coli (E.coli) and Haemophilus influenzae (H.influenzae) by ELISA in 24 patients (11 males and 13 females) with IgA nephropathy and 22 normal controls (11 males and 11 females). The titers of IgA and IgM antibodies for E.coli and H.influenzae were significantly higher in the IgA nephropathy group than in the controls. In addition, IgA and IgM antibody titers for E.coli and H.influenzae showed a significant positive correlation with serum IgA and IgM levels. These findings suggest that subclinical infection by these bacteria stimulates IgA production and that this may be a factor in the development and progression of IgA nephropathy.
Subject(s)
Antibodies, Bacterial/blood , Antigens, Bacterial/immunology , Glomerulonephritis, IGA/immunology , Adolescent , Adult , Antibodies, Bacterial/immunology , Antigens, Bacterial/blood , Child , Female , Glomerulonephritis, IGA/blood , Humans , Immunoglobulin Isotypes , Male , Middle AgedABSTRACT
To clarify the role of apolipoprotein E (apo E) in the formation of amyloid deposits, we examined specimens from 11 patients with renal amyloidosis who underwent renal biopsy by an immunohistochemical method using a monoclonal antibody (murine IgG1). Apo E was distributed in the amyloid deposits of all patients in a pattern similar to that obtained with Congo red staining. Strong positive staining for apo E was found on the amyloid deposits in the glomeruli. These results suggest that apo E is a common constituent of amyloid fibrils and that it may be a useful marker for immunohistochemical studies of systemic amyloidosis including renal amyloidosis.
Subject(s)
Amyloidosis , Apolipoproteins E/analysis , Kidney Diseases , Kidney/chemistry , Adult , Female , Humans , Immunohistochemistry , Male , Middle AgedABSTRACT
Transverse myelitis (TM) is a very rare complication of systemic lupus erythematosus (SLE) and its prognosis is poor. It therefore needs to be treated aggressively. We describe a patient suffering from SLE associated with TM, who responded well to a combination of immunoadsorption therapy and steroid mini-pulse therapy. His serum interleukin 6 levels as well as clinical indicators fell to normal after this treatment.
Subject(s)
Anti-Inflammatory Agents/therapeutic use , Immunosorbents/therapeutic use , Interleukin-6/metabolism , Lupus Erythematosus, Systemic/physiopathology , Myelitis, Transverse/drug therapy , Adult , Anti-Inflammatory Agents/administration & dosage , Blood Proteins/metabolism , Humans , Immunosorbent Techniques , Japan , Male , Myelitis, Transverse/diagnosis , Myelitis, Transverse/physiopathology , Phenylalanine/therapeutic use , Steroids , Treatment OutcomeABSTRACT
A 16-year-old female with IgA nephropathy harboring histologically active lesions was treated with steroid mini-pulse therapy. Immunohistochemical examination revealed a diffuse distribution of interleukin-6 (IL-6) in the renal biopsy tissue. After treatment, her clinical factors and renal function improved, and renal biopsy showed reduced histological lesions and disappearance of the IL-6 distribution. Immunohistological studies of cytokines, such as IL-6, may be useful for evaluating the therapeutic effects in IgA nephropathy.
Subject(s)
Glomerulonephritis, IGA/metabolism , Interleukin-6/metabolism , Kidney Glomerulus/metabolism , Steroids/administration & dosage , Adolescent , Female , Fluorescent Antibody Technique, Indirect , Glomerulonephritis, IGA/drug therapy , Glomerulonephritis, IGA/pathology , HumansABSTRACT
To determine whether immune system disorders are involved in the exacerbation of IgA nephropathy, the immunoglobulin production of peripheral blood mononuclear cells obtained from 45 IgA nephropathy patients was measured and then compared with that of healthy individuals. The level of IgA production was classified into an elevated group and a non-elevated group and comparisons were made with various clinical factors considered to be related to exacerbation of this disease. The results indicated that although there was no significant difference in immunoglobulin production of the peripheral mononuclear cells between IgA nephropathy cases and healthy individuals in the group not stimulated with pokeweed mitogen (PWM), the group stimulated with PWM revealed a production of IgA, IgG, and IgM which was significantly elevated (P less than 0.01). Also, within the group stimulated with PWM, hypertension, severe proteinuria and microscopic hematuria, elevated BUN and serum creatinine values, decreased 15-min PSP and creatinine clearance values, severe histological damage, and severe IgA deposition were observed more in the elevated IgA production group than in the non-elevated group. These findings suggest that an elevated IgA production plays an important role in the excerbation of this disease.
