Why the study?
Chronic kidney disease is associated with cardiovascular disease and endothelial glycocalyx degradation, prompting an analysis of plasma perlecan across CKD stages and its relationship to inflammatory monocytes.
Are plasma perlecan levels elevated in patients with chronic kidney disease compared to healthy subjects?
Are plasma perlecan levels elevated in patients with chronic kidney disease compared to healthy subjects?
Plasma perlecan levels are elevated in advanced CKD and dialysis patients and correlate with increased ICAM-1 expression on monocytes, suggesting its potential as a biomarker for endothelial damage and cardiovascular risk.
Answers are grounded in this paper and cite their sources.
Elevated perlecan may mark endothelial damage and monocyte activation in CKD; leaves open its value as a CVD biomarker pending prospective studies.
Background and Aims Chronic kidney disease (CKD) is associated with cardiovascular disease (CVD). CVD is in turn related to endothelial dysfunction, endothelial dysfunction, and degradation of the endothelial glycocalyx (EG), releasing its components into the bloodstream. The EG consists of glycosaminoglycans and proteoglycans, such as Perlecan. The aim of the study is to analyse the levels of perlecan in plasma in different stages of CKD, and to relate them to age and inflammatory monocytes, as well as their adhesion capacity (CD54/ICAM-1). Method An observational cross-sectional study was carried out. 56 patients were included: advanced chronic kidney disease (ACKD) (n=13), haemodialysis (HD) (n=13), peritoneal dialysis (PD) (n=15) and transplant recipients (TX) (n=15). Thirteen healthy subjects (CT) were analysed. Plasma perlecan levels were quantified using ELISA and phenotyping of monocyte subpopulations (classical (CD14++CD16-), intermediate (CD14+CD16+) and non-classical (CD14+CD16++)), as well as CD54 (ICAM-1) expression by flow cytometry. Statistical analysis: ANOVA and Spearman correlation. Results Patients with CKD had higher plasma levels of perlecan than healthy participants (p-value = 0.044 vs ACKD, 0.028 vs HD and 0.002 vs PD) (Fig. 1). These levels were associated with higher percentage of classical monocytes (p=0,011) intermediate monocytes (p=0,009) and non-classical monocytes (p=0,003) expressing ICAM-1 but not with a higher expression of ICAM-1 per monocyte. Perlecan levels correlate negatively with age (p=0,03) (Table 1). Conclusion Patients with ACKD, HD and PD have elevated plasma perlecan levels compared to CT and TX. Elevated perlecan concentrations are associated with increased ICAM-1 expression on monocytes, which is important for its possible role in the development of atherosclerosis. Perlecan may be postulated as a molecule of interest to assess endothelial and cardiovascular damage in CKD patients.
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Arévalo et al. (2023) studied this question.
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