1. Online Hemodiafiltration Inhibits Inflammation-Related Endothelial Dysfunction and Vascular Calcification of Uremic Patients Modulating miR-223 Expression in Plasma Extracellular Vesicles.
- Author
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Cavallari C, Dellepiane S, Fonsato V, Medica D, Marengo M, Migliori M, Quercia AD, Pitino A, Formica M, Panichi V, Maffei S, Biancone L, Gatti E, Tetta C, Camussi G, and Cantaluppi V
- Subjects
- Adult, Aged, Endothelium, Vascular metabolism, Endothelium, Vascular pathology, Female, Human Umbilical Vein Endothelial Cells, Humans, Inflammation blood, Inflammation immunology, Inflammation pathology, Inflammation therapy, Male, Middle Aged, Endothelium, Vascular immunology, Extracellular Vesicles immunology, Extracellular Vesicles metabolism, Gene Expression Regulation immunology, Hemodiafiltration, MicroRNAs blood, MicroRNAs immunology, Renal Insufficiency, Chronic blood, Renal Insufficiency, Chronic immunology, Renal Insufficiency, Chronic pathology, Renal Insufficiency, Chronic therapy, Uremia blood, Uremia immunology, Uremia pathology, Uremia therapy, Vascular Calcification blood, Vascular Calcification immunology, Vascular Calcification pathology, Vascular Calcification therapy
- Abstract
Decreased inflammation and cardiovascular mortality are evident in patients with end-stage chronic kidney disease treated by online hemodiafiltration. Extracellular vesicles (EV) are mediators of cell-to-cell communication and contain different RNA types. This study investigated whether mixed online hemodiafiltration (mOL-HDF) beneficial effects associate with changes in the RNA content of plasma EV in chronic kidney disease patients. Thirty bicarbonate hemodialysis (BHD) patients were randomized 1:1 to continue BHD or switch to mOL-HDF. Concentration, size, and microRNA content of plasma EV were evaluated for 9 mo; we then studied EV effects on inflammation, angiogenesis, and apoptosis of endothelial cells (HUVEC) and on osteoblast mineralization of vascular smooth muscle cells (VSMC). mOL-HDF treatment reduced different inflammatory markers, including circulating CRP, IL-6, and NGAL. All hemodialysis patients showed higher plasma levels of endothelial-derived EV than healthy subjects, with no significant differences between BHD and mOL-HDF. However, BHD-derived EV had an increased expression of the proatherogenic miR-223 with respect to healthy subjects or mOL-HDF. Compared with EV from healthy subjects, those from hemodialysis patients reduced angiogenesis and increased HUVEC apoptosis and VSMC calcification; however, all these detrimental effects were reduced with mOL-HDF with respect to BHD. Cell transfection with miR-223 mimic or antagomiR proved the role of this microRNA in EV-induced HUVEC and VSMC dysfunction. The switch from BHD to mOL-HDF significantly reduced systemic inflammation and miR-223 expression in plasma EV, thus improving HUVEC angiogenesis and reducing VSMC calcification., (Copyright © 2019 by The American Association of Immunologists, Inc.)
- Published
- 2019
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