Email this article Significance of the markers of endothelial dysfunction and hemorheological disorders for assessing the activity and prognosis of chronic glomerulonephritis
- Authors: Smyr K.V.1, Shcherbak A.V.2, Kozlovskaya L.V.1, Sokolova I.A.3, Bobkova I.N.2, Podorol'skaya L.V.4, Smyr KV5, Shcherbak AV6, Kozlovskaya LV5, Sokolova IA7, Bobkova IN6, Podorovskaya LV8
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Affiliations:
- ММА им. И. М. Сеченова
- НИЦ ММА им. И. М. Сеченова
- Институт механики, МГУ им. Ломоносова
- МГУ им. М. В. Ломоносова
- Department of Therapy and Occupational Diseases
- Department of Nephrology, Research Center, I. M. Sechenov Moscow Medical Academy
- Institute of Mechanics, M. V. Lomonosov Moscow State University
- Biology Faculty, M. V. Lomonosov Moscow State University
- Issue: Vol 82, No 1 (2010)
- Pages: 47-51
- Section: Editorial
- URL: https://journals.rcsi.science/0040-3660/article/view/33398
- ID: 33398
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Abstract
Subjects and methods. Sixty-one patients, including 30 with hematuric nephritis (Group 1) and 31 with nephrotic nephritis (Group 2), were examined. A control group consisted of 12 healthy individuals. The rheological properties of blood, such as its viscosity; kinetics of spontaneous aggregation and disaggregation of red blood cells in shear flow; their deformability; urinary excretion of functionally active von Willebrandt factor (WF), a plasminogen activator inhibitor type 1 (PAI-1); urine total fibrinolytic activity (UTFA), activity of urinary urokinase-type plasminogen activator (UPA) were studied.
Results. The patients with CGN were found to have signs of impaired blood rheological properties (increased viscosity, an accelerated rapid phase of erythrocyte aggregation, increased strength of erythrocyte aggregates) and vascular endothelial dysfunction in the microcirculatory bed, among other factors, increased urinary excretion of functionally active WF, PAI-1, which correlated with the activity of CGN. Data were obtained on the negative impact of the level of urinary PAI-1 excretion, red blood cell aggregation on the prognosis of CGN regardless of its form, the markers of endothelial damage/ activation. Low urokinase activity and decreased red blood cell deformability in parallel with higher diurnal proteinuria are of poor prognostic value for hematuric nephritis.
Conclusion. The findings illustrate two ways of the involvement of the endothelium in the mechanisms contributing to the development of tubular interstitial fibrosis, namely: endothelial dysfunction and as a substrate that links the processes of immune inflammation, hemorheology, and fibrinolysis/proteolysis in the kidney. The regularities revealed by clinical and laboratory comparison suggest that the indices under study may be used to determine the prognosis of the disease and may serve as a basis for the application of treatments aimed at correcting the detected disorders.
About the authors
Kseniya Vyacheslavovna Smyr
ММА им. И. М. Сеченова
Email: ksmyr@yandex.ru
ст. лаборант, каф. терапии, внутренних и профессиональных болезней ММА им. И. М. Сеченова; ММА им. И. М. Сеченова
Anna Vladimirovna Shcherbak
НИЦ ММА им. И. М. Сеченова
Email: annard@yandex.ru
канд. мед. наук, ст. науч. сотр., отд. нефрологии НИЦ ММА им. И. М. Сеченова; НИЦ ММА им. И. М. Сеченова
Lidiya Vladimirovna Kozlovskaya
ММА им. И. М. Сеченовад-р мед. наук, проф., каф. терапии внутренних и профессиональных болезней; ММА им. И. М. Сеченова
Irina Anatol'evna Sokolova
Институт механики, МГУ им. Ломоносова
Email: sokol@imec.msu.ru
д-р биол. наук, лаб. биомеханики; Институт механики, МГУ им. Ломоносова
Irina Nikolaevna Bobkova
НИЦ ММА им. И. М. Сеченовад-р мед. наук, зав. отд. нефрологии НИЦ; НИЦ ММА им. И. М. Сеченова
Lidiya Vasil'evna Podorol'skaya
МГУ им. М. В. Ломоносова
Email: tnserb@mail.ru
канд. биол. наук, ст. науч. сотр., лаб. ферментативного фибринолиза; МГУ им. М. В. Ломоносова
K V Smyr
Department of Therapy and Occupational DiseasesDepartment of Therapy and Occupational Diseases
A V Shcherbak
Department of Nephrology, Research Center, I. M. Sechenov Moscow Medical AcademyDepartment of Nephrology, Research Center, I. M. Sechenov Moscow Medical Academy
L V Kozlovskaya
Department of Therapy and Occupational DiseasesDepartment of Therapy and Occupational Diseases
I A Sokolova
Institute of Mechanics, M. V. Lomonosov Moscow State UniversityInstitute of Mechanics, M. V. Lomonosov Moscow State University
I N Bobkova
Department of Nephrology, Research Center, I. M. Sechenov Moscow Medical AcademyDepartment of Nephrology, Research Center, I. M. Sechenov Moscow Medical Academy
L V Podorovskaya
Biology Faculty, M. V. Lomonosov Moscow State UniversityBiology Faculty, M. V. Lomonosov Moscow State University
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