End-stage renal disease (ESRD) patients are subjected to enhanced oxidative stress. Excess of reactive oxygen species (ROS) may lead to the functional disabilities of lymphocytes. The aim of the study was to investigate the effect of vitamin E and N-acetylcysteine (NAC) on antioxidant status and intracellular oxidative stress in T-cells in children treated with dialysis.
Material and methods: 18 children treated with dialysis (hemodialysis n = 5 and peritoneal dialysis n = 13) were enrolled into the study. The age range was 2-20 ys. with a mean of 10.94 +/-5.86 ys. Vitamin E and NAC were given for six months orally. Throughout the study total antioxidant status (TAS), superoxide dismutase (SOD) and glutathione peroxidase (GPx) activity, and intracellular oxidative stress in T lymphocytes was measured.
Results: In children treated with dialysis, TAS was significantly reduced compared to the controls (p = 0.012). We found no differences in GPx and SOD activities between patient and control groups. Mean fluorescence intensity (MFI), which reflected intracellular oxidative stress, was significantly increased in: CD3+, CD3+CD4- and CD8+CD28-. After six months of antioxidant treatment, a significant reduction in MFI was noted in most T-cell subsets (p < 0.001). MFI in T-helper cells remained unchanged. Although there was a trend toward rise in TAS and GPx activity, only significant differences in SOD activity were found (p = 0.022).
Conclusions: In children with ESRD treated with dialysis reduced TAS coexists with enhanced intracellular oxidative stress in T lymphocytes. The combined treatment with vitamin E and NAC lead to the reduction in oxidative stress within T-cells that might be of therapeutic value in dialyzed patients.