PMID- 17389624
OWN - NLM
STAT- MEDLINE
DCOM- 20070817
LR  - 20070528
IS  - 0931-0509 (Print)
IS  - 0931-0509 (Linking)
VI  - 22
IP  - 6
DP  - 2007 Jun
TI  - Enoxaparin but not unfractionated heparin causes a dose-dependent increase in 
      plasma TGF-beta 1 during haemodialysis: a cross-over study.
PG  - 1690-6
AB  - BACKGROUND: Transforming growth factor-beta1 (TGF-beta1) is a multi-functional 
      cytokine that presents as a mediator of the heparin's pleiotropic action. In this 
      cross-over study, we compared the effects of enoxaparin and unfractionated 
      heparin (UFH) used as anticoagulants during haemodialysis (HD) on plasma 
      TGF-beta1 levels and some platelet activation markers: platelet-derived growth 
      factor-AB (PDGF-AB), beta-thromboglobulin (beta-TG) and platelet factor-4 (PF-4). 
      METHODS: Plasma immunoreactive markers (in 22 chronically HD patients) were 
      quantified at the start, at 10 and 180 min of HD session. Enoxaparin was 
      administered as a single dose of 0.67 +/- 0.14 mg/kg at the onset of HD, while 
      UFH was given as a bolus of 1500 (500-3500) IU followed by an infusion of 2750 
      (1500-6500) IU. The time of evaluation for each heparin was 3 months. RESULTS: 
      Pre-dialysis, TGF-beta1 levels tended to be lower in patients anticoagulated with 
      enoxaparin compared with UFH [6.9 (3.3-21.9) ng/ml vs 8.4 (3.8-30.2) ng/ml, 
      respectively; P = 0.05]. Overdialysis, TGF-beta1 levels showed a significant 
      44.8% increase to 10.0 (2.9-28.0) ng/ml after 10 min (P = 0.002) and to 9.32 
      (5.3-23.7) ng/ml after 180 min (P = 0.016) of enoxaparin-anticoagulated HD and 
      remained stable during UFH administration [9.4 (3.9-25.3) ng/ml after 10 min, 8.1 
      (4.1-21.9) ng/ml after 180 min; P = 0.385]. The 35% increase in plasma TGF-beta1 
      after 180 min of HD positively correlated with the enoxaparin dose/kg (r = 0.553, 
      P = 0.008) and, interestingly, negatively with the baseline level of the cytokine 
      (r = -0.544, P = 0.009). Despite a positive correlation between TGF-beta1 and 
      PDGF-AB during HD, there were no associations between TGF-beta1 and beta-TG or 
      PF-4 regardless of the type of anticoagulation. CONCLUSION: Enoxaparin, compared 
      with UFH, induces a rapid overdialytic but not sustained increase in plasma 
      TGF-beta1 levels. The effect is closely dose-dependent and may reflect systemic 
      activation of this multi-potential cytokine.
FAU - Naumnik, Beata
AU  - Naumnik B
AD  - Department of Nephrology and Transplantation with Dialysis Unit, Medical 
      University, 14 Zurawia Street, 15-540 Bialystok, Poland. bnaumnik@poczta.onet.pl
FAU - Borawski, Jacek
AU  - Borawski J
FAU - Pawlak, Krystyna
AU  - Pawlak K
FAU - Mysliwiec, Michal
AU  - Mysliwiec M
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
DEP - 20070326
PL  - England
TA  - Nephrol Dial Transplant
JT  - Nephrology, dialysis, transplantation : official publication of the European 
      Dialysis and Transplant Association - European Renal Association
JID - 8706402
RN  - 0 (Anticoagulants)
RN  - 0 (Enoxaparin)
RN  - 0 (Transforming Growth Factor beta1)
RN  - 9005-49-6 (Heparin)
SB  - IM
MH  - Aged
MH  - Anticoagulants/administration & dosage/*therapeutic use
MH  - Cross-Over Studies
MH  - Dose-Response Relationship, Drug
MH  - Enoxaparin/administration & dosage/*therapeutic use
MH  - Female
MH  - Heparin/*administration & dosage
MH  - Humans
MH  - Male
MH  - *Renal Dialysis
MH  - Transforming Growth Factor beta1/biosynthesis/*blood
EDAT- 2007/03/29 09:00
MHDA- 2007/08/19 09:00
CRDT- 2007/03/29 09:00
PHST- 2007/03/29 09:00 [pubmed]
PHST- 2007/08/19 09:00 [medline]
PHST- 2007/03/29 09:00 [entrez]
AID - gfm082 [pii]
AID - 10.1093/ndt/gfm082 [doi]
PST - ppublish
SO  - Nephrol Dial Transplant. 2007 Jun;22(6):1690-6. doi: 10.1093/ndt/gfm082. Epub 
      2007 Mar 26.