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High‐density lipoprotein from end‐stage renal disease patients exhibits superior cardioprotection and increase in sphingosine‐1‐phosphate
Author(s) -
Brinck Jonas W.,
Thomas Aurélien,
BrulhartMeynet MarieClaude,
Lauer Estelle,
Frej Cecilia,
Dahlbäck Björn,
Stenvinkel Peter,
James Richard W.,
Frias Miguel A.
Publication year - 2018
Publication title -
european journal of clinical investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.164
H-Index - 107
eISSN - 1365-2362
pISSN - 0014-2972
DOI - 10.1111/eci.12866
Subject(s) - medicine , endocrinology , kidney disease , oxidative stress , high density lipoprotein , cholesterol , lipoprotein , apolipoprotein b
Abstract Background Chronic kidney disease ( CKD ) exacerbates the risk of death due to cardiovascular disease ( CVD ). Modifications to blood lipid metabolism which manifest as increases in circulating triglycerides and reductions in high‐density lipoprotein ( HDL ) cholesterol are thought to contribute to increased risk. In CKD patients, higher HDL cholesterol levels were not associated with reduced mortality risk. Recent research has revealed numerous mechanisms by which HDL could favourably influence CVD risk. In this study, we compared plasma levels of sphingosine‐1‐phosphate (S1P), HDL ‐associated S1P ( HDL ‐S1P) and HDL ‐mediated protection against oxidative stress between CKD and control patients. Methods High‐density lipoprotein was individually isolated from 20 CKD patients and 20 controls. Plasma S1P, apolipoprotein M (apoM) concentrations, HDL ‐S1P content and the capacity of HDL to protect cardiomyocytes against doxorubicin‐induced oxidative stress in vitro were measured. Results Chronic kidney disease patients showed a typical profile with significant reductions in plasma HDL cholesterol and albumin and an increase in triglycerides and pro‐inflammatory cytokines ( TNF ‐alpha and IL ‐6). Unexpectedly, HDL ‐S1P content ( P = .001) and HDL cardioprotective capacity ( P = .034) were increased significantly in CKD patients. Linear regression analysis of which factors could influence HDL ‐S1P content showed an independent, negative and positive association with plasma albumin and apoM levels, respectively. Discussion The novel and unexpected observation in this study is that uremic HDL is more effective than control HDL for protecting cardiomyocytes against oxidative stress. It is explained by its higher S1P content which we previously demonstrated to be the determinant of HDL ‐mediated cardioprotective capacity. Interestingly, lower concentrations of albumin in CKD are associated with higher HDL ‐S1P.