Association between vascular calcification scores on plain radiographs and fatty acid contents of erythrocyte membrane in hemodialysis patients.

OBJECTIVE: Vascular calcification (VC) scores determined by using simple plain radiographic films are known to be associated with coronary artery disease and mortality in patients undergoing hemodialysis (HD). Omega-3 fatty acid (FA) has been shown to reduce ectopic calcifications in an animal model, and it has also been shown that erythrocyte membrane omega-3 FA content is an independent discriminator of coronary artery disease. The present study was designed to demonstrate relations between VC scores and erythrocyte membrane FA contents in patients undergoing HD. DESIGN: A cross-sectional study was carried out. SETTING: The study was carried out at an outpatient hemodialysis unit at Dong-A University Hospital, Busan, Republic of Korea. PATIENTS: A total of 31 patients undergoing HD were recruited. Patients with significant malnutrition, a short duration of dialysis (<12 months), a history of recent infection, malignancy, or liver disease were excluded. MAIN OUTCOME MEASURES: Plain radiographic films of the feet, hands, pelvis, and lateral lumbar spine were examined and VC scores were determined using previously reported methods. Erythrocyte membrane FA contents were analyzed by gas chromatography. RESULTS: The erythrocyte membrane contents of eicosapentaenoic acid and docosahexaenoic acid were not found to be related with VC on simple plain radiographic films. However, erythrocyte membrane contents of oleic acid and total monounsaturated FA (MUFA) were significantly higher in patients with significant VC scores. Furthermore, erythrocyte membrane contents of MUFA and oleic acid were found to be negatively associated with high-density lipoprotein cholesterol level and positively associated with triglyceride level. CONCLUSION: Erythrocyte membrane contents of MUFA and oleic acid were found to be associated with VC scores determined using plain radiographs and with dyslipidemia in patients undergoing HD.

Early mitochondrial hyperpolarization and intracellular alkalinization in lactacystin-induced apoptosis of retinal pigment epithelial cells.

We investigated the induction and underlying mechanism of apoptosis in retinal pigment epithelial cells by the inhibition of proteasome activity using lactacystin. Rat retinal pigment epithelial cell line retinal pigment epithelial (RPE)-J was used in this study. Apoptosis was evaluated by light and electron microscopies, DNA electrophoresis, and terminal deoxynucleotidyl transferase dUTP nick-end labeling assay. The apoptosis-related proteins were localized in the cells by immunofluorescent microscopy, and the changes of their protein contents and the enzyme activation were monitored by Western blot. Mitochondrial membrane potential was quantified by measuring J aggregate (5,5',6,6'-tetrachloro-1,1',3,3'-tetraethylbenzimidazol carbocyanine iodide) fluorescence. To measure changes in intracellular pH, cells were loaded with 2',7'-bis(carboxyethyl)-5(6')-carboxyfluorescein and assayed by flow cytometry. To elucidate the type of transport system involving intracellular pH regulation, several transporter inhibitors were used, and their effect on pH and membrane potential was assayed as described above. Lactacystin treatment significantly induced apoptosis in RPE-J cells. During the RPE cell apoptosis, 1) cytochrome c and Smac/DIABLO were released into cytosol from mitochondria, 2) translocation of apoptosis-inducing factor to the nucleus was evident, 3) Bax protein seemed to translocate to mitochondria, 4) procaspase-3 and poly(ADP-ribose) polymerase were cleaved, and 5) nuclear condensation and DNA fragmentation were clearly observed. Noticeably, a transient increase of mitochondrial membrane potential was coincidentally detected with the intracellular alkalinization after lactacystin administration. Furthermore, the lactacystin-induced early alkalinization was inhibited by 4-acetamido-4'-isothiocyanostilbene-2,2'-disulfonate, an inhibitor of Cl(-)/HCO(3)(-) anion exchanger, which also prevented early mitochondrial hyperpolarization and apoptosis. Lactacystin-induced apoptosis in RPE-J cells is closely associated with an early mitochondrial hyperpolarization induced by intracellular alkalinization.