Abstract: 【Abstract】Objective To analyze the expression changes of nuclear factor E2 related factor 2 (Nrf2) and quinone oxidoreductase (NQO1) in peripheral mononuclear cells and tumor necrosis factor α (TNF-α) and interleukin 6 (IL-6) in serum in uremic hemodialysis patients. Methods A total of 46 uremic patients treated with hemodialysis for more than 6 months in our hospital from June 2015 to August 2017 were recruited as the dialysis group, and 37 newly diagnosed uremic patients were enrolled as the non-dialysis group. In addition, 25 healthy subjects were recruited as the healthy group. Hemoglobin (Hb), serum TNF-α, IL-6, albumin (Alb), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), and the mRNA and protein levels of Nrf2 and NQO1 in mononuclear cells were assayed. These laboratory results in dialysis group were compared with those in non-dialysis group and healthy group. Results Serum TNF-α, IL-6, TC, and LDL-C were significantly higher in dialysis group and non-dialysis group than in healthy group (For TNF-α, t=6.937, P＜0.001 in dialysis group; t=8.462, P＜0.001 in non- dialysis group. For IL- 6, t=8.068, P＜0.001 in dialysis group; t=8.937, P＜0.001 in non- dialysis group. For TC, t=2.301, P=0.024 in dialysis group; t=4.338, P＜0.001 in non-dialysis group. For LDL-C, t=4.489, P＜0.001 in dialysis group; t=7.032, P＜0.001 in non-dialysis
group). Serum Alb and Hb were significantly lower in dialysis group and non- dialysis group than in healthy group (For Alb, t=6.040, P＜0.001 in dialysis group; t=4.266, P＜0.001 in non- dialysis group. For Hb, t=3.859, P＜0.001 in dialysis group; t=2.478, P=0.016 in non-dialysis group). Serum TNF-α, IL-6, TC,
LDL-C, Alb and Hb were significantly lower in dialysis group than in non- dialysis group (For TNF-α, t=2.205, P=0.030. For IL-6, t=2.327, P=0.022. For TC, t=2.123, P=0.037. For LDL-C, t=2.106, P=0.038. For Alb, t=2.357, P=0.021. For Hb, t=2.179, P=0.032). The relative mRNA levels of Nrf2 and NQO1 in peripheral mononuclear cells were significantly lower in dialysis group and non-dialysis group than in healthy group (For Nrf2, t=9.525, P＜0.001 in dialysis group; t=7.858, P＜0.001 in non-dialysis group. For NQO1, t=7.517, P＜0.001 in dialysis group; t=9.046, P＜0.001 in non-dialysis group), and were significantly lower in dialysis group than in non-dialysis group (For Nrf2, t=2.612, P=0.011. For NQO1, t=2.523, P=0.014). The relative protein levels of Nrf2 and NQO1 in peripheral mononuclear cells were significantly lower in dialysis group and non-dialysis group than in healthy group (For Nrf2, t=7.345, P＜0.001 in dialysis group; t=6.107, P＜0.001 in non- dialysis group. For NQO1, t=6.247, P＜0.001 in dialysis group; t=7.689, P＜0.001 in non- dialysis group), and were significantly lower in dialysis group than in non-dialysis group (For Nrf2, t=2.351, P=0.021. For NQO1, t=2.207, P=0.030). In dialysis group, serum TNF-α and IL-6 were negatively correlated with Alb and Hb (For TNF-α/Alb, r=-0.672, P＜0.001. For IL-6/Alb, r=-0.654, P＜0.001. For TNF-α/Hb, r=-0.521, P=0.001. For IL-6/Hb, r=-0.537, P＜0.001), positively correlated with TC and LDL-C (For TNF-α/TC, r=0.574, P＜0.001. For IL- 6/TC, r=0.412, P=0.005. For TNF- α/LDL- C, r= 0.618, P＜0.001. For IL- 6/LDL- C, r=0.622, P＜0.001), and negatively correlated with the expression of Nrf2 and NQO1 (For TNF- α/ Nrf2, r=-0.726, P＜0.001. For IL-6/ Nrf2, r=-0.732, P＜0.001. For TNF-α/ NQO1, r=-0.714, P＜0.001. For IL-6/ NQO1, r=- 0.721, P＜0.001). In dialysis group, the expression level of Nrf2 was positively correlated with that of NQO1 (r= 0.691, P＜0.001). Conclusion In uremic patients, the endogenous antioxidant capacity
was reduced and the body was in an inflammation status. These abnormalities were resulted from malnutrition, lipid metabolism disturbances and anemia.

Key words: Hemodialysis, Peripheral blood mononuclear cells, Tumor necrosis factor α, Nuclear factor E2 related factor 2, Quinone oxidoreductase