Análise de componentes do sistema purinérgico em pacientes com doença renal crônica antes e após protocolo de acupuntura auricular

Abstract

To maintain systemic homeostasis, renal patients are submitted to renal replacement therapies, such as hemodialysis. Chronic renal patients generally have an inflammatory state, in this perspective, the purinergic system is one of the mediators and signalizers of the inflammatory and anti-inflammatory processes. Of the constituents of this system, the adenosine triphosphate molecule and the ectonucleotidases NTPdase 1 and Ecto-5'-nucleotidase stand out. Therapies such as auricular acupuncture have been used for the management of several pathological situations, including chronic kidney disease. The present research is a quantitative and interventional study that sought to evaluate the amount of adenosine triphosphate and the activity of ectonucleotidases in chronic renal failure patients on hemodialysis who received auricular acupuncture. The auricular acupuncture protocol was closed and lasted 12 weeks. GraphPad Prism 8 software and tests appropriate for the sample were used for statistical analysis, namely: Dixon, Wilcoxon, Shapiro-Wilk, Student T-test. The study had a mean age of 57.39 years (14.51) (n=33 patients). The most prevalent pathology was autoimmune glomerulopathies. Moreover, it was noted that after the auricular acupuncture protocol there was a reduction in the amount of extracellular ATP, in the enzymatic activity of NTPdase 1 related to ATP and ADP hydrolysis, and of Ecto-5'-nucleotidase related to AMP hydrolysis, both significant analyses. After the application of the proposed protocol, a reduction in the pro-inflammatory environment mediated by the purinergic system is suggested.