Relationship among endothelial response to hyperemia, bone marrow-derived progenitor cells, and parathyroid hormone in renal transplantation.

Department of Medical and Surgical Critical Care, Thrombosis Center, University of Florence, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy.
Transplantation (Impact Factor: 3.78). 02/2012; 93(8):835-41. DOI: 10.1097/TP.0b013e318247a75d
Source: PubMed

ABSTRACT Endothelial dysfunction may contribute to modulate cardiovascular complications in renal transplant recipients (RTRs), and a relationship between endothelial dysfunction and parathyroid hormone (PTH) levels in RTRs has been demonstrated. We evaluated the relationship between endothelial response to hyperemia and circulating progenitor cells (CPCs) and endothelial progenitor cells (EPCs) PTH, and genetic parameters in RTRs.
In 120 RTRs and in healthy subjects without (n=107, group A) and with cardiovascular risk factors (n=109, group B), we evaluated endothelial response to hyperemia through digital tonometry (peripheral arterial tonometry) detected by reactive hyperemia index (RHI) and EPCs and CPCs by flow cytometry.
In RTRs, RHI median value was lower than in group A (P=0.05). EPC number was significantly lower in RTRs than in groups A and B (P<0.0001), whereas PTH median value was significantly higher (P<0.0001). In RTRs, RHI values were significantly lower according to the presence of three or more risk factors (P=0.04) and positively correlated with EPCs (P=0.04) but not with PTH (P=0.2). In patients who underwent dialysis for more than 5 years, lower RHI values (P=0.08), EPC number (P=0.5), and higher PTH concentrations (P=0.09) than in patients with less than 1 year dialysis time were observed. No relationship between eNOS gene -786T>C, 894G>T, and 4a/4b polymorphisms and RHI, EPC, and CPC number was found.
This study shows an altered endothelial response, associated with reduced EPCs, and increased PTH in RTRs; the evaluation of endothelial status in RTRs may contribute to better assess the risk profile of these patients.

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    ABSTRACT: BACKGROUND: Peripheral-arterial tonometry (PAT) provides, with good reproducibility, measures of nitric oxide-mediated endothelial response, which correlate with flow-mediated dilation (FMD) findings obtained by brachial artery ultrasound. Few data about the ability of exploring endothelial function by PAT in relation to dietary habits are available. The aim of this study was to evaluate natural logarithm of reactive hyperemia index (lnRHI) in subjects referred for primary prevention, in relation to classic risk factors, in particular to adherence to Mediterranean diet and red wine consumption. METHODS: The study population was composed of 95 consecutive clinically stable subjects in primary prevention for cardiovascular diseases. All subjects underwent medical questionnaire, clinical examination, and PAT for endothelial function evaluation. RESULTS: A significant inverse correlation between lnRHI values and body mass index (r = -0.284; P = 0.022) was found. We described a gradual reduction in lnRHI values, corresponding to the increase in the number of risk factors (0.75 [0.31-1.26], 0.66 [0.25-0.97], 0.63 [0.37-1.19], 0.48 [0.32-0.71], 0.43 [0.31-0.91], respectively, for none, 1, 2, 3, and 4 cardiovascular risk factors; P = 0.004). A significant positive correlation between score of adherence to Mediterranean diet and lnRHI values was found (r = 0.307; P = 0.002). Higher adherence to Mediterranean diet was found in subjects with lnRHI values greater than 0.40 in comparison to others (39 [27-50] vs 33 [28-45], respectively; P = 0.064). The lnRHI values were significantly higher in regular drinkers in comparison to nonregular drinkers (0.46 [0.25-0.83] vs 0.70 [0.32-1.26], respectively; P < 0.0001).Relationship between reactive hyperemia index and red wine consumption remained statistically significant even after adjustment for age, sex, body mass index, smoking habit, hypertension, and adherence to Mediterranean diet. CONCLUSIONS: Our findings strengthen the ability of PAT to evaluate alterations of endothelium response to ischemia, in relation to physiological and clinical conditions, so indicating possible usefulness to optimize and personalize risk stratification.
    Journal of Investigative Medicine 04/2013; · 1.50 Impact Factor


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May 30, 2014