Mattinzoli Deborah, Turolo Stefano, Alfieri Carlo Maria, Ikehata Masami, Caldiroli Lara, Armelloni Silvia, Montini Giovanni, Agostoni Carlo, Messa Piergiorgio, Vettoretti Simone, Castellano Giuseppe
Renal Research Laboratory, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy.
Pediatric Nephrology, Dialysis and Transplant Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy.
J Clin Med. 2022 Nov 30;11(23):7099. doi: 10.3390/jcm11237099.
Fibroblast growth factor 23 (FGF23) concentrations rise after the early stages of chronic kidney disease (CKD). FGF23 is involved in inflammatory reactions closely associated with an incremented risk of cardiovascular disease (CVD). There is growing evidence that omega-6 (n-6) and n-3 polyunsaturated fatty acids (PUFA) can modulate inflammation through several mediators producing an opposite effect on cardiovascular (CV) risks. In this study, we explore whether there is any correlation between PUFA, FGF23, and inflammation in CKD patients. We evaluated, cross-sectionally, 56 patients at different stages of CKD. Monocyte chemoattractant protein 1 (MCP1), and intact and c-terminal FGF23 (iFGF23, cFGF23) were quantified by the ELISA, and the fatty acids (FA) profile was analyzed by gas chromatography. Concurrently with an eGFR decrease (p < 0.01) and an MCP1 increase (p = 0.031), we observed an inversion of the correlation between FGF23 and the n-6/n-3 ratio. This last correlation was inversed in CKD stage 3 (r2 (−) 0.502 p = 0.029) and direct in stage 5 (r2 0.657 p = 0.020). The increase in MCP1 seems to trigger events in the inversion of the correlation between FGF23 and the n-6/n-3 PUFA ratio. This result strongly encourages future studies on basal pathways, on possible pharmacological interventions, and on managing kidney transplant patients treated with immunosuppressive therapy.
慢性肾脏病(CKD)早期过后,成纤维细胞生长因子23(FGF23)浓度会升高。FGF23参与了与心血管疾病(CVD)风险增加密切相关的炎症反应。越来越多的证据表明,ω-6(n-6)和n-3多不饱和脂肪酸(PUFA)可通过多种介质调节炎症,对心血管(CV)风险产生相反的影响。在本研究中,我们探讨了CKD患者中PUFA、FGF23和炎症之间是否存在关联。我们对56例处于不同CKD阶段的患者进行了横断面评估。通过酶联免疫吸附测定法(ELISA)对单核细胞趋化蛋白1(MCP1)、完整型和C端FGF23(iFGF23、cFGF23)进行定量,并通过气相色谱法分析脂肪酸(FA)谱。随着估算肾小球滤过率(eGFR)降低(p < 0.01)和MCP1升高(p = 0.031),我们观察到FGF23与n-6/n-3比值之间的相关性发生了反转。在CKD 3期,这种相关性呈负相关(r2(-)0.502,p = 0.029),而在5期呈正相关(r2 0.657,p = 0.020)。MCP1的升高似乎触发了FGF23与n-6/n-3 PUFA比值之间相关性反转的事件。这一结果有力地推动了未来关于基础通路、可能的药物干预以及对接受免疫抑制治疗的肾移植患者管理的研究。