Martin_et_al-2018-Physiological_Reports.pdf (661.11 kB)
Download fileExercise during hemodialysis does not affect the phenotype or pro-thrombotic nature of microparticles but alters their pro-inflammatory function
journal contribution
posted on 14.08.2018, 10:49 authored by Naomi Martin, Alice C. Smith, Maurice Dungey, Hannah M.L. Young, James O. Burton, Nicolette BishopNicolette BishopHemodialysis patients have dysfunctional immune systems, chronic inflammation
and comorbidity-associated risks of cardiovascular disease (CVD) and
infection. Microparticles are biologically active nanovesicles shed from activated
endothelial cells, immune cells, and platelets; they are elevated in
hemodialysis patients and are associated with chronic inflammation and predictive
of CVD mortality in this group. Exercise is advocated in hemodialysis
to improve cardiovascular health yet acute exercise induces an increase in circulating
microparticles in healthy populations. Therefore, this study aimed to
assess acute effect of intradialytic exercise (IDE) on microparticle number and
phenotype, and their ability to induce endothelial cell reactive oxygen species
(ROS) in vitro. Eleven patients were studied during a routine hemodialysis
session and one where they exercised in a randomized cross-over design.
Microparticle number increased during hemodialysis (2064–7071 microparticles/lL,
P < 0.001) as did phosphatidylserine+ (P < 0.05), platelet-derived
(P < 0.01) and percentage procoagulant neutrophil-derived microparticles
(P < 0.05), but this was not affected by IDE. However, microparticles collected
immediately and 60 min after IDE (but not later) induced greater ROS
generation from cultured endothelial cells (P < 0.05), suggesting a transient
proinflammatory event. In summary IDE does not further increase prothrombotic
microparticle numbers that occurs during hemodialysis. However, given
acute proinflammatory responses to exercise stimulate an adaptation toward a
circulating anti-inflammatory environment, microparticle-induced transient
increases of endothelial cell ROS in vitro with IDE may indicate the potential
for a longer-term anti-inflammatory adaptive effect. These findings provide a
crucial evidence base for future studies of microparticles responses to IDE in
view of the exceptionally high risk of CVD in these patients.
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