Enhanced scavenger receptor expression in monocyte-macrophages in dialysis patients

The macrophage scavenger receptor (SR), which has two isoforms named type I and II, plays a leading role in the atherosclerotic process. To elucidate the mechanism of atherosclerosis in dialysis patients, SR expression was studied in monocyte-macrophages from thirteen dialysis patients and eight healthy controls. SR mRNA expression was examined in four hemodialysis patients and four controls matched for age and sex. Monocytes were allowed to differentiate into macrophages in in vitro cultures for seven days and SR type I and II mRNA expression were analyzed with the reverse transcription-polymerase chain reaction and quantitated using radiation densities of Southern blots. Only SR type I expression increased during differentiation and was accelerated by one or two days and enhanced after five days in patients, as compared to controls. To detect SR protein expression, uptake of fluorescently labeled acetylated low-density lipoprotein (Ac-LDL) was evaluated by flow cytometry. The mean fluorescence intensity of labeled cells was significantly higher in hemodialysis and continuous ambulatory peritoneal dialysis patients than in controls, although the number of SR-positive cells remained constant. In conclusion, SR expression is enhanced in macrophages from dialysis patients, probably by up-regulation of type I, which may contribute to the development of atherosclerosis in these patients.