Marian Goicoechea1, Maria Dolores Sanchez-Niño2, Alberto Ortiz2, Soledad García de Vinuesa3, Borja Quiroga4, Carmen Bernis4, Enrique Morales5, Gema Fernández-Juarez6, Patricia de Sequera7, Ursula Verdalles3, Eduardo Verde3, José Luño3. 1. Servicio de Nefrología, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Spanish Kidney Research Network (REDINREN), Madrid, Spain. Electronic address: marian.goicoechea@gmail.com. 2. Instituto de Investigación Sanitaria, Fundación Jiménez Díaz (IIS-FJD UAM), Madrid, Spain; Spanish Kidney Research Network (REDINREN), Madrid, Spain. 3. Servicio de Nefrología, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Spanish Kidney Research Network (REDINREN), Madrid, Spain. 4. Hospital Universitario La Princesa, Madrid, Spain. 5. Hospital Universitario Doce de Octubre, Madrid, Spain; Spanish Kidney Research Network (REDINREN), Madrid, Spain. 6. Hospital Universitario Fundación Alcorcón, Madrid, Spain; Spanish Kidney Research Network (REDINREN), Madrid, Spain. 7. Hospital Universitario Infanta Leonor, Madrid, Spain.
Abstract
BACKGROUND: Resolution of inflammation is regulated by endogenous lipid mediators, such as lipoxins and their epimers, including 15-epi-lipoxin A4 (15-epi-LXA4). However, there is no information on 15-epi-LXA4 and its in vivo regulation in chronic kidney disease (CKD) patients. STUDY DESIGN: Open label randomized clinical trial. SETTING AND PARTICIPANTS: 50 participants with chronic kidney disease (CKD) stage 3 and 4 without prior cardiovascular disease (25 in the aspirin group and 25 in the standard group) followed for 46 months. INTERVENTION: Aspirin (100mg/day) or standard treatment. AIM: To analyze the effect of aspirin on plasma 15-epi-LXA4 levels and inflammatory markers in CKD patients. RESULTS:Baseline plasma15-epi-LXA4 levels were lower in diabetic (1.22 ± 0.99ng/ml) than in non-diabetic CKD patients (2.05 ± 1.06ng/ml, p < 0.001) and inversely correlated with glycosylated hemoglobin levels (r = -0.303, p = 0.006). In multivariate analysis, diabetes was associated with lower 15-epi-LXA4 levels, adjusted for age, inflammatory markers and renal function (p = 0.005). In the whole study population, 15-epi-LXA4 levels tended to increase, but not significantly (p = 0.45), after twelve months on aspirin (from mean ± SD 1.84 ± 1.06 to 2.04 ± 0.75ng/ml) and decreased in the standard care group (1.60 ± 1.15 to 1.52 ± 0.68ng/ml, p = 0.04). The aspirin effect on 15-epi-LXA4 levels was more striking in diabetic patients, increasing from 0.94 ± 0.70 to 1.93 ± 0.74ng/ml, p = 0.017. CONCLUSIONS:Diabetic patients withCKD have lower circulating 15-epi-LXA4 levels than non-diabetic CKD patients. Low dose aspirin for 12 months increased 15-epi-LXA4 levels in diabetic patients. Given its anti-inflammatory properties, this increase in 15-epi-LXA4 levels may contribute to the beneficial effects of low dose aspirin.
RCT Entities:
BACKGROUND: Resolution of inflammation is regulated by endogenous lipid mediators, such as lipoxins and their epimers, including 15-epi-lipoxin A4 (15-epi-LXA4). However, there is no information on 15-epi-LXA4 and its in vivo regulation in chronic kidney disease (CKD) patients. STUDY DESIGN: Open label randomized clinical trial. SETTING AND PARTICIPANTS: 50 participants with chronic kidney disease (CKD) stage 3 and 4 without prior cardiovascular disease (25 in the aspirin group and 25 in the standard group) followed for 46 months. INTERVENTION: Aspirin (100mg/day) or standard treatment. AIM: To analyze the effect of aspirin on plasma 15-epi-LXA4 levels and inflammatory markers in CKDpatients. RESULTS: Baseline plasma15-epi-LXA4 levels were lower in diabetic (1.22 ± 0.99ng/ml) than in non-diabetic CKDpatients (2.05 ± 1.06ng/ml, p < 0.001) and inversely correlated with glycosylated hemoglobin levels (r = -0.303, p = 0.006). In multivariate analysis, diabetes was associated with lower 15-epi-LXA4 levels, adjusted for age, inflammatory markers and renal function (p = 0.005). In the whole study population, 15-epi-LXA4 levels tended to increase, but not significantly (p = 0.45), after twelve months on aspirin (from mean ± SD 1.84 ± 1.06 to 2.04 ± 0.75ng/ml) and decreased in the standard care group (1.60 ± 1.15 to 1.52 ± 0.68ng/ml, p = 0.04). The aspirin effect on 15-epi-LXA4 levels was more striking in diabeticpatients, increasing from 0.94 ± 0.70 to 1.93 ± 0.74ng/ml, p = 0.017. CONCLUSIONS:Diabeticpatients with CKD have lower circulating 15-epi-LXA4 levels than non-diabetic CKDpatients. Low dose aspirin for 12 months increased 15-epi-LXA4 levels in diabeticpatients. Given its anti-inflammatory properties, this increase in 15-epi-LXA4 levels may contribute to the beneficial effects of low dose aspirin.
Authors: Patrizia Natale; Suetonia C Palmer; Valeria M Saglimbene; Marinella Ruospo; Mona Razavian; Jonathan C Craig; Meg J Jardine; Angela C Webster; Giovanni Fm Strippoli Journal: Cochrane Database Syst Rev Date: 2022-02-28
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