应用SELDI-TOF-MS技术建立胰腺癌筛选血清蛋白指纹图谱模型

目的：建立胰腺癌筛选血清蛋白质指纹图谱模型。方法：应用表面增强激光解析离子化飞行时间质谱（SELDI-TOF-MS）技术,采用弱阳离子交换芯片（CM10）首先对33例胰腺癌患者和31例性别年龄匹配的健康对照血清蛋白表达谱的差异进行了分析,建立决策树分类模型。结果：在质荷比（M/Z）2000～20000范围内,共检测到185个有效蛋白峰,其中12个峰差异有显著性（P〈0.01）。自动选用M/Z为11674.7和7771.2的2个差异蛋白峰,建立胰腺癌决策树分类模型,其灵敏度为96.97%（32/33）,特异度为96.67%（30/31）。结论：应用SELDI-TOF-MS技术可以筛选出胰腺癌相关的血清蛋白标志,建立的决策树模型可能对胰腺癌的诊断具有重要的临床价值。     

利用SELDI-TOF质谱技术分析大肠癌患者血清蛋白质谱的变化

目的：研究大肠癌血清蛋白质谱的变化，从而筛选特异性蛋白标志物。 方法： 利用IMAC3蛋白质芯片和SELDI-TOF质谱技术，对64例大肠癌病人和40名正常人的血清蛋白质谱进行分析。获得的蛋白质谱采用Ciphergen公司的Biomarker Wizard和Biomarker Pattern软件分析。 结果： 通过对大肠癌术前血清与正常人血清蛋白质谱分析发现共有19个蛋白质表达量有明显差异。并获得分子量为5 972.67 D、5 927.21 D、6 113.48 D、5 908.55 D和4 292.51 D这5个蛋白质组成的模板，可将大肠癌与正常人正确分组，其正确分组率分别为97.5％（56/64）和80％（32/40）。术后血清蛋白质谱中，原高表达的蛋白质明显下调。 结论： 结果表明通过大肠癌手术前后及正常对照血清中蛋白质谱的比较，筛选得到用以诊断大肠癌的特异性蛋白标志物并用以预后的判断。SELDI-TOF蛋白质芯片技术为建立蛋白质模板从而早期诊断大肠癌提供了可靠的技术平台。     

类风湿性关节炎疾病相关的特异性血清蛋白标志物

目的运用蛋白质指纹图谱技术筛选类风湿性关节炎(RA)患者血清中的特异性标志物,建立RA疾病相关的蛋白质组学诊断模型。方法采用弱阳离子纳米磁性微珠捕获血清蛋白,ProteinChip PBSII-C型蛋白质芯片阅读仪分别绘制性别年龄匹配的43例RA患者组及100例对照组(包括自身免疫性疾病对照组50例和正常对照组50例)的血清蛋白质指纹图谱,经Biomarker Wizard3.1软件分析蛋白峰后,再用Biomarker Patterns Software5.0软件筛查与RA疾病诊断密切相关的特异性血清蛋白标志物,建立RA诊断模型。结果在RA患者组中找到34个蛋白峰与对照组具有统计学差异(P<0.05),经Biomarker Patterns Software5.0软件识别,发现其中四个质荷比(m/z)分别为4966.89,5065.3,5636.97,7766.88的蛋白峰联合起来作为诊断模型,辨别RA患者及对照组的敏感性为86.36%,特异性为92.16%。对患者标本进行双盲验证,该诊断模型对RA的诊断敏感性为85.71%,特异性为87.76%。结论采用弱阳离子纳米磁性微珠与蛋白质芯片阅读仪联用的蛋白质指纹...     

SELDI-TOF-MS技术筛选NSCLC血清肿瘤标志物

目的 分析非小细胞肺癌(NSCLC)血清蛋白表达谱的改变,筛选并建立NSCLC血清蛋白的差异表达谱。方法 应用表面增强激光解析电离化飞行时间质谱(SELDI-TOF-MS,简称SELDI-TOF或SELDI)技术,分析100例NSCLC患者和100例正常对照血清,获得蛋白表达图谱。用Biomarker Pattern(BPS)软件分析NSCLC差异蛋白并初步建立诊断模型。通过盲筛进一步验证诊断模型。结 果 发现NSCLC患者血清与正常人有16个显著差异的蛋白波峰,显著高表达8个（P<0.001）。显著低表达8个（P<0.001）。经BPS软件分析,建立分类树模型,其诊断的灵敏度为100％,特异度为100％。100例样本盲筛验证结果显示,其灵敏度为96.15％,特异度为95.83％。无吸烟史患者较有吸烟史患者血清中显著高表达蛋白质波峰有3个（P<0.05）。鳞癌患者较腺癌患者血清中显著高表达蛋白质波峰有2个（P<0.01）。不同病理分期患者之间未发现差异蛋白峰。结 论 SELDI-TOF-MS 技术可筛选出NSCLC差异性蛋白并建立NSCLC诊断的分类树模型,有望成为NSCLC早期诊断的辅助指标。     

胃腺癌血清蛋白质标志物的筛选及鉴定

目的: 探讨并鉴定胃腺癌患者血清中肿瘤相关蛋白作为特异性标志物的可能性。方法: 应用表面增强激光解吸电离飞行时间质谱(SELDI-TOF-MS)技术检测109例胃腺癌和106例对照(60健康者、30例慢性浅表性胃炎和16例慢性萎缩性胃炎)的血清标本,应用生物信息学方法筛选差异蛋白峰,经高效液相色谱(HPLC)分离出差异蛋白,酶解后进行液质联用串联质谱(LC-MS/MS)分析,利用Xcalibur的程序组件Bioworks 3.2完成蛋白质序列数据库鉴定分析。结果: 经SELDI-TOF-MS技术筛选出m/z位于5 906.5的蛋白质标志物在胃腺癌中高表达(胃腺癌组表达强度为8.53±4.33,正常组表达强度为0.88±0.31),显著差异(P<0.01);6 635.7和8 716.3的蛋白质标志物在胃腺癌中低表达(胃腺癌组表达强度为6.54±2.44和0.93±0.29,正常组表达强度为17.56±4.43和2.16±0.98),差异显著(P<0.01)。联合上述3种潜在蛋白质标志物,区别胃腺癌组和对照组的灵敏度为93.85%(61/65),特异性为94.34%(50/53)。对m/z为5 906.5、6 635.7和8 716.3的标志物进行鉴定,结果分别为纤维蛋白原α链、载脂蛋白 A-II和载脂蛋白 C-I。结论: 鉴定出的纤维蛋白原α链、载脂蛋白 A-II和载脂蛋白 C-I在胃腺癌的诊断中具有一定价值和广泛应用前景,值得进一步研究和探讨。     

构建腰椎间盘突出症血瘀证的血清蛋白指纹图谱模型

背景：腰椎间盘突出症血瘀证与非血瘀证的相互关系尚不明确。目的：构建腰椎间盘突出症血瘀证的血清蛋白指纹图谱模型。方法：按照病例对照研究方法,遵循组间民族、性别及年龄等相匹配原则筛选180例研究对象,其中120例分为腰椎间盘突出症血瘀证组及腰椎间盘突出症非血瘀证组,每组60例;健康对照组60例。抽取受试者外周血的血清样本,应用表面增强激光解吸/电离飞行时间质谱及蛋白质芯片技术检测并绘制蛋白质质谱图,随后用Biomarker Wizard软件识别蛋白峰信息,建立腰椎间盘突出症血瘀证的血清诊断模型,并通过双盲验证法对模型进行验证及通过ExPASy数据库对相关差异蛋白进行蛋白检索。结果与结论：在腰椎间盘突出症血瘀证、腰椎间盘突出症非血瘀证及健康者各组之间找到11个蛋白质峰有统计学意义(P < 0.05),其中2个蛋白质呈高表达、9个蛋白质呈低表达;用Biomarker Patterns Software构建腰椎间盘突出症血瘀证血清学诊断模型并验证,其敏感性为86.667%,特异性为94.167%,阳性预测值为88.136%。表明腰椎间盘突出症血瘀证患者的血清中存在多种异常表达的蛋白质;由11个差异蛋白组成的血清蛋白质指纹图谱模型可作为腰椎间盘突出症血瘀证的血清标志物诊断模型。 中国组织工程研究杂志出版内容重点：肾移植;肝移植;移植;心脏移植;组织移植;皮肤移植;皮瓣移植;血管移植;器官移植;组织工程全文链接：     

应用蛋白质谱建立活动性肺结核病的血清诊断模型

目的 应用蛋白质谱技术研究活动性肺结核病患者的血清诊断标志物,建立诊断模型早期诊断活动性肺结核.方法 应用表面加强激光解吸-电离飞行时间质谱技术(SELDI-TOF-MS)和蛋白芯片技术检测264例活动性肺结核患者、其他呼吸疾病患者和正常人血清;应用Ciphergen蛋白芯片3.1.1软件比较、分析血清蛋白峰,找出差异蛋白;应用Biomarker Pattern 5.0软件建立活动性肺结核的诊断模型.结果 129例活动性肺结核血清和135例对照血清蛋白指纹图谱比较,有50个差异蛋白峰(P<0.01).以69例其他呼吸疾病血清和66例健康人血清为对照,选择5个蛋白峰(4360、3311、8160、5723、15173 m/z)建立诊断模型1,该模型诊断活动性肺结核的灵敏度为82.95%,特异性为89.63%,准确率为86.36%.以69例其他呼吸疾病血清为对照,选择3个蛋白峰(5643、4486、4360 m/z)建立诊断模型2,该模型诊断活动性肺结核的灵敏度为96.9%,特异性为97.8%,准确率为97.3%.结论 应用蛋白质谱技术分析肺结核病患者血清可能建立一种新的结核病早期诊断方法 .     

慢性肾功能衰竭患者外周血细胞CD146的表达及意义

目的 探讨CD146在慢性肾功能衰竭(CRF)患者外周血细胞中的表达及意义.方法 收集本院2007年8月至2009年7月门诊及住院CRF患者51例为CRF组,33例正常人为健康对照组,流式细胞术检测两组外周血细胞CD146的表达并比较两组之间的差异,分析CRF患者外周血细胞CD146表达与血尿素氮(BUN)、血肌酐(Scr)的相关性.结果 与对照组比较,CRF组单核细胞、中性粒细胞CD146+细胞百分率及CD45-CD146+细胞数量均显著升高[(4.09±3.48)%比(0.20±0.10)%;(4.71±3.94)%比(0.79±0.14)%;(16.43±10.48)个/μl比(2.16±0.81)个/μl,均P<0.001].CRF患者外周血CD45-CD146+细胞数量与BUN、Scr均呈正相关(r=0.480、0.595,均P<0.01).结论 外周血单核细胞及中性粒细胞CD146的表达及升高与CRF的发生有关,CD45-CD146+细胞数量增加与CRF的发生及严重程度有关.     

SELDI-TOF-MS技术检测心绞痛患者血浆蛋白指纹图谱的研究

目的： 采用表面增强激光解析/电离飞行时间质谱（SELDI-TOF-MS）技术检测心绞痛患者血浆蛋白质指纹图谱,从中筛选出特异的分子标志物。方法: 应用SELDI-TOF-MS技术及金属离子螯合（IMAC-3）蛋白质芯片对20例心绞痛患者和29例正常对照者血浆样本进行检测,借助生物信息学工具（非线性的支持向量机,SVM）提出心绞痛的诊断模型,并运用留一交叉验证法来评估该模型的判别效能。结果: 用SELDI-TOF-MS技术筛选出由3个有显著差异的蛋白质峰［质荷比（m/z）分别为2 667.3、5 914.0和6 890.5］组合构建的诊断模型,可将20例心绞痛患者和29例正常人全部正确分组,诊断特异性和灵敏度均为100%。结论: SELDI-TOF-MS技术在心绞痛的诊断中具有较高灵敏度和特异性,发现的蛋白质峰可能在心绞痛的发病中起一定作用,血浆中分子标志物的发现有助于心绞痛的早期诊断。     

交感神经皮肤反应对评价慢性肾功能不全患者植物神经损害的意义

目的:探讨慢性肾功能不全(CRF)患者交感神经皮肤反应(SSR)的变化及其临床意义。方法:对52例CRF患者行SSR检测,并与32例正常对照组比较。结果:CRF组SSR波幅低于正常对照组,潜伏期较对照组延长(P<0.01)。CRF组SSR总异常率为71%,其中上肢异常率为48%,下肢异常率为71%;慢性肾衰早期组16例中7例(44%)SSR异常,慢性肾衰组19例中14例(74%)SSR异常,尿毒症组17例中16例(94%)SSR异常;CRF患者上下肢之间、不同亚组之间SSR异常率比较差异有极显著意义(P<0.01)。CRF组病程和血肌酐水平与SSR潜伏期间的偏相关系数分别为0.4732(P<0.01)和0.3247(P<0.05),而与SSR波幅间的偏相关系数为-0.3173和-0.3062(P均<0.05);年龄与SSR潜伏期偏相关系数为0.0434(P>0.05),与SSR波幅偏相关系数为-0.4445(P<0.01)。结论:SSR的异常反映了CRF患者常合并交感神经损害,且与病程、肾功能损害程度及年龄因素相关,SSR检测可作为评价CRF患者交感神经损害敏感的客观指标。     

Mechanisms of neutrophil apoptosis in uremia and relevance of the Fas (APO-1, CD95)/Fas ligand system

The regulation of neutrophil apoptosis in chronic renal failure (CRF) has not been clearly defined. The Fas/FasL system is an important apoptotic regulatory pathway in a wide variety of cells. Fas is a widely expressed cell surface protein that transduces an apoptotic signal after interaction with its natural ligand FasL. In contrast to the extensive tissue distribution of Fas, constitutive expression of FasL is relatively limited. We examined Fas and FasL expression by neutrophils in healthy subjects, patients with CRF, and patients on hemodialysis (HD) and peritoneal dialysis (PD). Fas expression was significantly higher among patients with CRF compared with control subjects, HD patients, and PD patients. FasL expression was significantly higher among patients with CRF compared with control subjects. At 24 h, neutrophil apoptosis was higher among patients with CRF compared with control subjects. Furthermore, high-neutrophil Fas expression was paralleled by a higher sensitivity to Fas-mediated apoptosis. There was a strong correlation between Fas-stimulated apoptosis and creatinine clearance as well as Fas expression. Finally, we found that uremic serum increased the expression of neutrophil-associated Fas and FasL proteins, when compared with normal serum. Further studies are under way to examine the regulation of this pathway in the uremic environment.     

慢性肾衰竭血透患者血清瘦素水平及其意义

为探讨慢性肾衰竭（CRF）血透患者的血清瘦素水平及其与残余肾功能、人体构成和营养状况的关系，分别采用放射免疫分析技术、生物电阻 抗技术和常规生化方法测定31例终末期CRF血透患者的血清瘦素水平、人体构成和营养相关指标。结果显示，CRF患者血清瘦素水平显著高于对照组（P＜0．001）；瘦素水平与体重指数和脂肪百分比呈正相关，与去脂体重呈负相关（P均＜0．001），与肌酐清除率、血肌酐、尿素氮以及血白蛋白、胆固醇、血红蛋白无相关性（P均大于0．05）。结论：终末期CRF患者存在高瘦素血症，其瘦素水平与残余肾功能无关，但可能导致去脂体重丢失。瘦素可以作为评价机体脂肪含量的营养指标，但没有在终末期CRF患者蛋白质营养不良中发挥显著作用。     

Small gastrin (G-17) serum levels after stimulation with food during conservative treatment of patients with chronic renal insufficiency

The physiological release mechanism for gastrin is complex, including both mechanical and chemical stimuli. Distention of the antrum is the main mechanical stimulus, and proteins and their degradation products constitute the most potent chemical stimuli. The aim of the present study was to examine the little gastrin (G-17) response to a test meal and to study the relationship between the G-17 concentration and gastric acid secretion in patients with various degrees of chronic renal failure (CRF). In 14 CRF patients under conservative treatment and 12 healthy control subjects, fasting and stimulated G-17 concentrations, as well as basal (BAO), maximal (MAO) and peak acid secretion (PAO) were measured. Mean fasting serum G-17 in CRF patients was 7.8 +/- 0.8 pmol/L, significantly higher (p less than 0.001) than in control subjects (5.9 +/- 1 pmol/L). However, the range of basal G-17 concentrations in both groups of subjects was not different from the normal values (4.2 +/- 11.3 pmol/L). The serum G-17 response to the food stimulation was significantly higher (p less than 0.001) in the control subjects than in the CRF patients. In normal subjects, the increment in the serum G-17 concentration rose to a peak at 30 min, but in the CRF patients the peak increment occurred at 60 min, and the response was more prolonged. There was a little difference in meal-stimulated serum G-17 concentrations in patients with various degrees of renal functional impairment. Basal acid output (BAO) was significantly higher (p less than 0.001) in the control subjects (2.62 +/- 0.51 mmol/h) than in the CRF patients (1.68 +/- 0.4 mmol/h). No significant difference in both the maximal acid output (MAO) and peak acid output (PAO) was found between the groups of CRF patients and control subjects. There was no relationship between G-17 concentrations and the gastric acid output in the CRF patients. From the results of the present study it is concluded that the human kidney is unimportant in the catabolism of G-17 but that the renal failure seems to decrease the rate of the peripheral extraction of gastrin by other tissues. The raised basal and meal-stimulated G-17 concentrations sometimes seen in CRF patients are associated with decreased rather than increased gastric acid secretions.     

Elevation of pro-inflammatory cytokines, C-reactive protein and cardiac troponin T in chronic renal failure patients on dialysis

Chronic renal failure (CRF) patients suffer from a chronic inflammation. They are at increased risk of cardiovascular disease. In order to investigate this inflammatory process and cardiovascular risk factors associated with haemodialysis (HD) and peritoneal dialysis (PD), we compared serum/plasma pro-inflammatory cytokines, C-reactive protein (CRP), and cardiac troponin T (cTnT) of 146 CRF patients treated or not treated with PD or HD. Serum cytokines and CRP as well as plasma cTnT were measured by enzyme-linked immunosorbent assay, chemiluminescence immunoassay, and electrochemiluminescence immunoassay, respectively. Results indicated that serum interleukin (IL)-18 concentrations were significantly higher in PD and low creatinine clearance pre-dialysis CRF (LCC) patients than HD patients (both p < 0.05). IL-6 and tumour necrosis factor (TNF)-alpha concentrations were significantly higher in PD patients than LCC patients (both p < 0.01). Serum hsCRP and plasma cTnT in HD were significantly higher than LCC (both p < 0.01). The elevation of pro-inflammatory cytokines should play an important role in the chronic inflammation and increased cardiovascular risk of CRF patients on dialysis. We are evaluating further the diagnostic and prognostic applications of pro-inflammatory cytokines and biochemical inflammatory markers for these patients.     

Lymphocyte Transformation Test in Adult Patients with Minimal Change Nephrotic Syndrome

The lymphocyte transformation test was used to evaluate the cellular immune response in 31 adult patients with MCNS in comparison with 30 normal control and 49 patient (CRF, FSGN. MGN) control groups. The results showed that the stimulation indices of the lymphocytes in MCNS group were significantly lower than those of the normal control and patient control groups with the exception of CRF group.
In cross studies, lymphocytes obtained from normal individuals were incubated in homologous serum obtaitied from MCNS patients in relapse, and lymphocytes from MCNS patients in relapse were incubated in normal homologous AB serum. In both circumstances there was a depressed lymphocyte function which indicates that there is a defect in lymphocyte itself as well as a serum inhibitory factor(s) during the active stage of the MCNS. This depressed cellular immune response returned to normal level during remission of the patients with MCNS.     

Preventive effects of an oral sorbent on nephropathy in rats

Circulating uremic substances are thought to be involved in the progression of chronic renal failure (CRF). An oral adsorbent AST-120 (Kremezin) is effective in removing circulating uremic toxins from the gastrointestinal tract, and retards the progression of CRF. AST-120 is widely used as an approved drug in Japan for the treatment of undialyzed uremic patients to delay the progression of CRF. AST-120 attenuates the progression of glomerular sclerosis and interstitial fibrosis in a variety of experimental rat models of CRF. However, the mechanism by which AST-120 delays the progression of CRF had not been clear. We have demonstrated that indoxyl sulfate, a dietary protein metabolite, is a circulating uremic toxin stimulating glomerular sclerosis and interstitial fibrosis, and that AST-120 decreases the serum and urine levels of indoxyl sulfate by adsorbing its precursor, indole, in the intestine. The administration of indoxyl sulfate to uremic rats stimulated the expression of transforming growth factor (TGF)-beta1, tissue inhibitor of metalloproteinase (TIMP)-1 and pro-alpha1(I)collagen in the kidneys. Further, the administration of AST-120 to uremic rats reduced the extent of glomerular sclerosis and interstitial fibrosis as well as the renal expression of TGF-beta1 and TIMP-1, by reducing the serum and urine levels of indoxyl sulfate. We propose the protein metabolite hypothesis that endogenous protein metabolites such as indoxyl sulfate play an important role in the progression of CRF, and that AST-120 is effective in retarding the progression of CRF by removing these protein metabolites through intestinal absorption.     

ILC2通过激活STAT6和分泌IL-13调节慢性肾功能衰竭患者的免疫功能

目的:探讨Ⅱ型固有淋巴细胞(ILC2)在慢性肾衰发生发展中的作用及其可能机制。方法:选择中山大学附属第一医院2016年3月~2016年12月入院的慢性肾功能衰竭患者36例,选取同期健康体检者32例为对照。流式细胞术(FCM)检测外周血单个核细胞(PBMC)中ILC2的比例;ELISA技术检测血浆中白细胞介素(IL)-13的浓度;提取慢性肾衰患者及健康对照者PBMC后分别分为3组(对照组、细胞因子刺激组、干预组)进行体外培养3 d后,ELISA法测定上清液中IL-13浓度;Western blot法对健康对照者PBMC在刺激前及刺激后15 min、30 min、1 h、2 h的转录活化因子6(STAT6)的磷酸化水平进行检测。结果:慢性肾功能衰竭患者PBMC中ILC2比例及血浆IL-13浓度均较健康人高(P0.05);体外培养上清液中,慢性肾功能衰竭患者的3个亚组中IL-13浓度均较健康人高(P0.05),且2类人群中均呈现出细胞因子刺激组较对照组升高,干预组较细胞因子刺激组降低的现象;Western blot结果显示p-STAT6的蛋白水平随时间的延长逐渐增高。结论:慢性肾衰患者外周血中ILC2的比例升高,同时ILC2内STAT6活化并分泌大量IL-13,介导Th2细胞的极化而调节免疫。     

Blood Serum Levels of IL-2, IL-6, IL-8, TNF-α and IL-1β in Patients on Maintenance Hemodialysis

Cytokines are essential mediators of immune response and inflammatory reactions. Patients with chronic renal failure (CRF) commonly present with abnormalities of immune function related with impaired kidney function and the accumulation of uremic toxins in addition to bioincompatibility of dialyzer membranes. During a hemodialysis (HD) session, cytokines are released mainly by monocytes activated by endotoxin-type compounds in dialyzer fluid, complement factors and direct contact with dialyzer membrane. The study included 15 CRF patients, aged 36.4±2.9 years, on regular HD maintenance therapy for mean 68±10 months and 15 healthy controls. It was designed to assess serum levels of a panel of inflammatory cytokines: IL-1β, IL-2, IL-6, IL-8 and TNF-αin CRF patients on regular maintenance HD before, 20, 60 and 240 minutes of a single HD session in parallel with C-reactive protein (CRP) as an additional parameter. CRP concentration was increased in HD patients when compared with healthy controls. The concentrations of IL-1, IL-6, IL-8 and TNF-αwere increased, whereas the serum level of IL-2 was not altered during a single HD session.     

Urinary indoxyl sulfate is a clinical factor that affects the progression of renal failure

We recently demonstrated that indoxyl sulfate is a stimulating factor for the progression of chronic renal failure (CRF). In this study we determined whether the urine or serum levels of indoxyl sulfate are related to the progression rate of CRF in undialyzed uremic patients. Fifty-five CRF patients with a serum creatinine of >2 mg/dl who had not been treated with an oral sorbent (AST-120) were randomly enrolled in the study. We measured the serum and urine levels of indoxyl sulfate, and estimated the recent progression rate of CRF as the slope of the reciprocal serum creatinine versus time (1/S-Cr-time) plot. The mean urinary amount of indoxyl sulfate in the patients was 60 mg/day. Those with indoxyl sulfate urine levels of >60 mg/day had a significantly faster progression rate of CRF than those with <60 mg/day. Especially, those patients with indoxyl sulfate urine levels of >90 mg/day had the highest CRF progression rate and those with indoxyl sulfate urine levels of <30 mg/day had the slowest CRF progression rate. Urinary indoxyl sulfate had a significantly negative correlation with the slope of the 1/S-Cr-time plot. However, the serum level of indoxyl sulfate or the ratio of serum indoxyl sulfate to creatinine was not significantly correlated with the slope of the 1/S-Cr-time plot. In conclusion, high urine levels of indoxyl sulfate are related with a rapid progression of CRF in undialyzed uremic patients. Thus, urinary indoxyl sulfate is one of the clinical factors that affect CRF progression.     

Citrate Attenuates Adenine-Induced Chronic Renal Failure in Rats by Modulating the Th17/Treg Cell Balance

Citrate is commonly used as an anticoagulant in hemodialysis for chronic renal failure (CRF) and for the regulation of the immune dysfunction in CRF patients. The objective of this study was to investigate the effect of citrate on the balance of T helper 17 (Th17) and regulatory T (Treg) cells in CRF. The levels of blood urea nitrogen (BUN) and serum creatinine (Scr) were significantly increased in the CRF model group compared to the control group, and were decreased in the citrate-treated groups. Citrate treatment inhibited the viability of Th17 cells while elevating the viability of Treg cells in CRF rats. Moreover, Th17-related cytokines significantly decreased while the Treg-related cytokines significantly increased with citrate treatment. Moreover, citrate had a negative influence on the deviation of Th17/Treg cells in CRF rats. Therefore, our study suggests that citrate had an anti-inflammatory effect on CRF through the modulation of the Th17/Treg balance.