Low dose aspirin increases 15-epi-lipoxin A4 levels in diabetic chronic kidney disease patients.

Abstract

BACKGROUND:

Resolution of inflammation is regulated by endogenous lipid mediators, such as lipoxins and their epimers, including 15-epi-lipoxin A4 (15-epi-LXA4). However, there is no information on 15-epi-LXA4 and its in vivo regulation in chronic kidney disease (CKD) patients.

STUDY DESIGN:

Open label randomized clinical trial.

SETTING AND PARTICIPANTS:

50 participants with chronic kidney disease (CKD) stage 3 and 4 without prior cardiovascular disease (25 in the aspirin group and 25 in the standard group) followed for 46 months.

INTERVENTION:

Aspirin (100mg/day) or standard treatment.

AIM:

To analyze the effect of aspirin on plasma 15-epi-LXA4 levels and inflammatory markers in CKD patients.

RESULTS:

Baseline plasma15-epi-LXA4 levels were lower in diabetic (1.22 ± 0.99ng/ml) than in non-diabetic CKD patients (2.05 ± 1.06ng/ml, p < 0.001) and inversely correlated with glycosylated hemoglobin levels (r = -0.303, p = 0.006). In multivariate analysis, diabetes was associated with lower 15-epi-LXA4 levels, adjusted for age, inflammatory markers and renal function (p = 0.005). In the whole study population, 15-epi-LXA4 levels tended to increase, but not significantly (p = 0.45), after twelve months on aspirin (from mean ± SD 1.84 ± 1.06 to 2.04 ± 0.75ng/ml) and decreased in the standard care group (1.60 ± 1.15 to 1.52 ± 0.68ng/ml, p = 0.04). The aspirin effect on 15-epi-LXA4 levels was more striking in diabetic patients, increasing from 0.94 ± 0.70 to 1.93 ± 0.74ng/ml, p = 0.017.

CONCLUSIONS:

Diabetic patients with CKD have lower circulating 15-epi-LXA4 levels than non-diabetic CKD patients. Low dose aspirin for 12 months increased 15-epi-LXA4 levels in diabetic patients. Given its anti-inflammatory properties, this increase in 15-epi-LXA4 levels may contribute to the beneficial effects of low dose aspirin.

• Authors: Marian Goicoechea, Maria Dolores Sanchez-Niño, Alberto Ortiz, Soledad García de Vinuesa, Borja Quiroga, Carmen Bernis, Enrique Morales, Gema Fernández-Juarez, Patricia de Sequera, Ursula Verdalles, Eduardo Verde, José Luño
• Journal: Prostaglandins, leukotrienes, and essential fatty acids (Prostaglandins Leukot Essent Fatty Acids) Vol. 125 Pg. 8-13 (Oct 2017) ISSN: 1532-2823 [Electronic] Scotland
• PMID: 28987723 (Publication Type: Journal Article, Multicenter Study, Randomized Controlled Trial)
• Copyright: Copyright © 2017 Elsevier Ltd. All rights reserved.

Chemical References

• Anti-Inflammatory Agents
• Lipoxins
• lipoxin A4
• Aspirin

Topics

• Aged
• Anti-Inflammatory Agents (therapeutic use)
• Aspirin (therapeutic use)
• Female
• Glomerular Filtration Rate (drug effects)
• Humans
• Lipoxins (blood)
• Male
• Middle Aged
• Renal Insufficiency, Chronic (blood, drug therapy)