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*
Institut National de la Santé et de la Recherche Médicale, Unit 90 and Department of Nephrology, Necker Hospital, Paris, France;
University Hospitals, Cleveland, OH 44106;
Centre National de la Recherche Scientifique, Unité de Recherche Associée 400, Paris, France; and
§
Division of Immunology and Allergy, University Hospital, Geneva, Switzerland
We previously demonstrated the presence of advanced oxidation
protein products (AOPP), a novel marker of oxidative stress in the
plasma of uremic patients receiving maintenance dialysis. The present
study in a cohort of 162 uremic patients showed that plasma
concentrations of AOPP increased with progression of chronic renal
failure and were closely related to advanced glycation end products
(AGE)-pentosidine (r = 0.52, p
< 0.001), taken as a marker of AGE. In vivo, the relevance of AOPP and
AGE-pentosidine in monocyte-mediated inflammatory syndrome associated
with uremia was evidenced by close correlations between AOPP or
AGE-pentosidine and monocyte activation markers, including neopterin,
IL-1R antagonist, TNF-
, and TNF soluble receptors (TNF-sR55 and
TNF-sR75). To determine the mechanisms by which AOPP and AGE could be
directly involved in monocyte activation, AOPP-human serum albumin
(HSA) and AGE-HSA were produced in vitro by treating HSA with oxidants
or glucose, respectively. Spectroscopic analysis confirmed that
AOPP-HSA contains carbonyls and dityrosine. Both AOPP-HSA and AGE-HSA,
but not purified dityrosine, were capable of triggering the oxidative
burst of human monocytes in cultures. The AOPP-HSA-induced respiratory
burst was dependent on the chlorinated nature of the oxidant and on the
molar ratio HSA/HOCl. Collectively, these data first demonstrate that
AOPP act as a mediator of oxidative stress and monocyte respiratory
burst, which points to monocytes as both target and actor in the immune
dysregulation associated with chronic uremia.
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