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ORIGINAL RESEARCH article

Front. Physiol.
Sec. Renal Physiology and Pathophysiology
Volume 15 - 2024 | doi: 10.3389/fphys.2024.1412235

Unveiling the Immunomodulator Role of Plasma Oxidized Lipids in SA-AKI Progression: A CRRT Perspective

Provisionally accepted
Lu Zhou Lu Zhou Huirong Li Huirong Li Wenfeng Guo Wenfeng Guo Lan Feng Lan Feng Jiangtao Hu Jiangtao Hu Jing Liu Jing Liu Tingting Wang Tingting Wang Hongbao Liu Hongbao Liu *
  • Department of Nephrology, Tangdu Hospital, Fourth Military Medical University, Xi'an, China

The final, formatted version of the article will be published soon.

    Background: Plasma oxidized lipids are intimately linked to immune regulation as bioactive mediators. However, it is not clear whether they are related to the progression of sepsis-associated acute kidney injury (SA-AKI) and the effect of continuous renal replacement therapy (CRRT). This study intends to explore the changes in certain oxidized lipid during CRRT treatment and their correlation with the immune microenvironment and prognosis by analyzing plasma oxidative lipidomics. Methods: A total of 48 SA-AKI patients undergoing CRRT for more than 72 hours were enrolled in this prospective cohort study. Oxidative lipidomics was analyzed by ultra performance liquid chromatography coupled with tandem mass spectrometric (UPLC-MS/MS) detection at the beginning of CRRT (T0) and 72 hours later (T72), respectively. Results: Compared with survivors, plasma EETs, EpOMEs and EpDPEs in non-survivors were significantly down-regulated at T0, while PGFs, TXB and HEPEs were up-regulated. After 72 hours of CRRT, DiHETEs were significantly up-regulated and PGFs were down-regulated in nonsurvivors, while HEPEs and EpOMEs were up-regulated and 6keto-PGF1α was down-regulated in survivors. KEGG annotation showed that the differential lipids of survivors before and after CRRT were mainly enriched and up-regulated in metabolic pathway. Conclusion: This study provided a comprehensive overview of plasma oxidized lipids in SA-AKI patients undergoing CRRT and further elucidated the lipids and pathways linked to patient severity and prognosis. Additionally, we unveiled the potential mechanisms by which CRRT improves the prognosis of SA-AKI patients by removing PGFs and TXs while simultaneously upregulating HEPE to ameliorate the immune microenvironment, as well as the potential significance of adjusting CRRT prescriptions based on plasma oxidized lipidomics.

    Keywords: Acute Kidney Injury, Sepsis, Oxidative lipidomics, prognosis, immune microenvironment, bioactive lipids

    Received: 25 Sep 2024; Accepted: 31 Oct 2024.

    Copyright: © 2024 Zhou, Li, Guo, Feng, Hu, Liu, Wang and Liu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Hongbao Liu, Department of Nephrology, Tangdu Hospital, Fourth Military Medical University, Xi'an, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.