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

• Published in: Prostaglandins, leukotrienes and essential fatty acids leukotrienes and essential fatty acids, 2017-10, Vol.125, p.8-13
• Main Authors: Goicoechea, Marian, Sanchez-Niño, Maria Dolores, Ortiz, Alberto, García de Vinuesa, Soledad, Quiroga, Borja, Bernis, Carmen, Morales, Enrique, Fernández-Juarez, Gema, de Sequera, Patricia, Verdalles, Ursula, Verde, Eduardo, Luño, José
• Format: Article
• Language: English
• Subjects: 15-epi-lipoxin A4; Aged; Anti-Inflammatory Agents - therapeutic use; Aspirin; Aspirin - therapeutic use; Chronic kidney disease; Clinical trial; Female; Glomerular Filtration Rate - drug effects; Humans; Inflammation; Lipoxins; Lipoxins - blood; Male; Middle Aged; Renal Insufficiency, Chronic - blood; Renal Insufficiency, Chronic - drug therapy
• ISSN: 0952-3278; 1532-2823
• DOI: 10.1016/j.plefa.2017.08.009

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. Open label randomized clinical trial. 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. Aspirin (100mg/day) or standard treatment. To analyze the effect of aspirin on plasma 15-epi-LXA4 levels and inflammatory markers in CKD patients. 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. 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. •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.•This increase in 15-epi-LXA4 levels may contribute to the beneficial effects of low dose aspirin in diabetic CKD patients.