Dynamics of circulating microparticles in chronic kidney disease and transplantation: Is it really reliable marker?

Abstract

The deterioration of endothelial structure plays a very important role in the development of vascular diseases. It is believed that endothelial dysfunction starts in the early stage of kidney disease and is a risk factor of an unfavorable cardiovascular prognosis. Because a direct assessment of biological states in endothelial cells is not applicable, the measurement of endothelial microparticles (EMPs) detached from endothelium during activation or apoptosis is thought to be a marker of early vascular disease and endothelial dysfunction in children with chronic kidney disease (CKD). Few studies have shown increased circulating EMPs and its relationship with cardiovascular risk factors in patients with CKD. MPs contain membrane proteins and cytosolic material derived from the cell from which they originate. EMPs having CD144, CD 146, CD31(+)/CD41(-), CD51 and CD105 may be used to evaluate the vascular endothelial cell damage and determine asymptomatic patients who might be at higher risk of developing cardiovascular disease in CKD and renal transplant.

Keywords: Chronic kidney disease; Endothelial dysfunction; Endothelial microparticles; Kidney transplantation.

Figure 1

Likely mechanisms leading to endothelial microparticle formation and release. ER: Endoplasmic reticulum; ROS: Reactive oxygen species; CRP: C-reactive protein; AT II: Angiotensin II; LPS: Lipopolysaccharide; MLCK: Myosin light chain kinase; ROCK I: Rho kinase I; MP: Microparticl; TNFα: Tumor necrosis factors α; IL-1: Interleukin-10; LDL: Low densith lipoprotein.