Evaluation of oxidative stress using exhaled breath 8-isoprostane levels on chronic kidney disease

Background: There have been limited numbers of studies on patients with chronic kidney disease (CKD) to determine oxidative stress in exhaled breath condensate (EBC). Those two studies have been carried out on hemodialysis patients, and hydrogen peroxide and nitric oxide have been studied in order to show oxidative stress on EBC.Aims: We investigated oxidative stress in EBC evaluating 8.isoprostane levels on different stages of CKD.Materials and Methods: A total of 81 patients with 2-4 CKD stages have been evaluated prospectively. The patients have been categorized into three groups according to their CKD stages. For biochemical analysis, blood and breathing air samples were taken. 8.-isoprostane has been measured using immunoassay method as the indicator of oxidative stress in EBC.Results: 8-isoprostane values were 8.19 ± 4.56, 13.89 ± 8.70, and 14.20 ± 10.68 pg/min group 1, 2, and 3, respectively; and the EBC 8-isoprostane levels increased significantly as CKD stages advanced (P = 0.018). There was a statistically significant reverse correlation between 8-isoprostane and glomerular filtration rate (GFR; r = .0.275; P = 0.014), but not between 8-isoprostane and Creactive protein (r = .0.183; P = 0.177).Conclusions: We determined the level of 8-isoprostane in EBC of patients with different stages of CKD and showed that the level of 8-isoprostane significantly increased through the progress of CKD. We consider that our study is important because there have been limited number of studies that evaluate oxidative stress in CKD using EBC which is a noninvasive method.Key words: 8-isoprostane, chronic kidney disease, exhaled breath condensate, oxidative stres

Hybrid Stromal Vascular Fraction (Hybrid-SVF): A New Paradigm in Mechanical Regenerative Cell Processing

Background:. Enzymatic digestion of extracellular matrix (ECM) from lipoaspirate is the conventional form of harvesting stromal vascular fraction (SVF) called enzymatically digested SVF (E-SVF). Mechanical SVF (M-SVF) isolation has emerged as an alternative method, but it has also some limitations in terms of lower cell viability and diminished cell counts. To enhance the SVF qualitatively and quantitatively, we propose a novel concept called "hybrid-SVF,” in which we combine M-SVF with the concentrated parts of adipose tissue after centrifugation, which is called stromal vascular matrix (SVM). Methods:. Hybrid-SVF injection was applied as an adjunctive therapy to fat grafting in 88 patients and 11 samples were evaluated in the laboratory for cell count, viability and cell activity. Results:. Experimental results determined that SVM part showed higher cellular activity. SVM and M-SVF showed higher cellular potency than E-SVF. Clinically, none of the patients required an additional session for fat grafting since there was no significant graft resorption. However, seven patients asked for further volume augmentation due to their individual preferences. No major complication was encountered. Conclusions:. The usage of hybrid-SVF has a very high regenerative potential due to the ECM support and exceptionally high cell yield in addition to preserved cell potency. Although there are ongoing studies focusing on optimizing cell counts and further clinical applications, we believe that our preliminary results might create a paradigm shift in the area of regenerative fat grafting