RESUMEN
BACKGROUND: The relationship between malnutrition in hemodialysis (HD) patients with a chronic inflammatory condition and the expression levels of leukocyte integrins and their adhesiveness to fibronectin was investigated. METHODS: Subjective global assessment, albumin and body mass index were used as nutritional markers to group malnourished (MP) and eutrophic (EP) patients. C-reactive protein was used as an inflammation marker. LFA-1, VLA-4 and VLA-5 expression levels on circulating leukocytes before and after HD were flow cytometrically measured; and their adhesiveness, through immobilized fibronectin. RESULTS: MPs showed significantly higher VLA-5 expression on granulocytes, when compared with healthy individuals (HPs) as controls (13.7% +/- 2.3% vs. 5.0% +/- 1.1%; p=0.005), particularly after HD (25.8% +/- 4.1%; p<0.001). They also presented a significantly lower ability to adhere to fibronectin when compared with EPs, before HD (48.8% +/- 1.5% vs. 62.3% +/- 0.7%; p<0.001) and after HD (50.6% +/- 1.2% vs. 65.7% +/- 1.4%; p<0.0001). Increased numbers of circulating immature neutrophils were observed only in MPs. CONCLUSIONS: Although presenting higher VLA-5 expression, malnutrition in HD patients is associated with impairment of the adhesive capacity of circulating leukocytes, particularly younger neutrophils, which may contribute to the chronic inflammatory status of these patients.
