Biocompatibility and buffers: Effect of bicarbonate-buffered peritoneal dialysis fluids on peritoneal cell function

Jörres, Achim; Bender, Thorsten O.; Finn, André; Witowski, Janusz; Fröhlich, Sibylle; Gahl, Gerhard M.; Frei, Ulrich; Keck, H.; Passlick–Deetjen, Jutta

doi:10.1046/j.1523-1755.1998.00178.x

Cited by 77 publications

(64 citation statements)

References 62 publications

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“…29 An inhibition of IL-1β activity was also shown in human endothelial cells cultured in hyperosmolar media. 30 We speculate that hyperosmolar media could affect IL-1β function in 1 or more ways.…”

Section: Discussionmentioning

confidence: 91%

Effect of Hyperosmolality on β-Defensin Gene Expression by Human Corneal Epithelial Cells

Narayanan

Manning²,

Proske³

et al. 2006

Cornea

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Purpose-As human β-defensins (hBD) are important antimicrobial peptides at epithelial surfaces, including the ocular surface, we tested the effect of hyperosmolar conditions on the expression of these peptides by human corneal epithelial cells (HCECs).Methods-Simian virus 40-transformed HCECs (n = 5) or primary cultured HCECs (n = 5) were treated with serum-free media or serum-free hyperosmolar (400-500 mOsm/kg) media for 24 hours or serum-free 500 mOsm/kg media for 12 to 48 hours. The effect of hyperosmolality on interleukin-1β (IL-1β)-induced hBD-2 expression was also tested. IL-6 expression was studied as a marker of IL-1β function. Expression of hBD-1, -2, and -3 and IL-6 mRNA was detected by reverse transcription-polymerase chain reaction (RT-PCR). The levels of active IL-1β (culture supernatants and cell lysates) and pro-IL-1β (cell lysates) were detected by enzyme-linked immunosorbent assay.Results-HCECs constitutively expressed hBD-1 and -3 but not hBD-2. Hyperosmolar media had no effect on the basal expression of hBD-1 or -3 and did not induce the expression of hBD-2. Treatment with 500 mOsm/kg media for 24 hours decreased the ability of IL-1β to upregulate hBD-2 and IL-6 expression. Active or pro-IL-1β was not detected in any cell culture sample.Conclusion-Our results suggest that the hyperosmolar environment observed in diseases such as dry eye does not alter defensin expression. However, a hyperosmolar environment may influence cytokine function in ocular surface cells and thus affect their response to injury and inflammation. Keywords hyperosmolality; human β-defensins; corneal epithelium; cytokines Hyperosmolality at the ocular surface is a characteristic of diseases such as dry eye and diabetes mellitus. The normal osmolality of the tear fluid is approximately 300 mOsm/kg, 1 whereas the suggested "gold standard" diagnostic of dry eye is 312 mOsm/kg or greater. 2 It has been proposed that tear fluid hyperosmolality occurs because of either normal tear evaporation associated with reduced tear flow or excessive tear evaporation with a normal tear flow. 3 The hyperosmolar tear film is thought to affect ocular surface epithelial function and differentiation in dry eye disease, with osmolalities as high as 417 mOsm/kg being reported. 1,4,5 Also, Aragona et al 6 showed that type 1 diabetic patients had a significantly higher mean tear osmolality (332.2 ± 18.3 mOsm/L), poor tear stability, altered tear function, and symptoms of ocular irritation akin to patients with dry eye than normal patients. Hyperosmolality in diabetes mellitus is probably attributable to increased levels of tear glucose seen in patients with both types 1 and 2. 7

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Section: Discussionmentioning

confidence: 91%

Effect of Hyperosmolality on β-Defensin Gene Expression by Human Corneal Epithelial Cells

Narayanan

Manning²,

Proske³

et al. 2006

Cornea

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“…Various components of dialysate-including buffer, low pH, glucose concentration, and GDPs generated during heat sterilization-can influence peritoneal sclerosis (14). In rat models, the presence of the catheter partly induces PD-related morphology changes (15,16).…”

Section: Discussionmentioning

confidence: 99%

Peritoneal Morphology after Long-Term Peritoneal Dialysis with Biocompatible Fluid: Recent Clinical Practice in Japan

Ayuzawa¹,

Ishibashi

Takazawa³

et al. 2012

Perit Dial Int

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♦ Background: Morphology changes of the peritoneal membrane after long-term peritoneal dialysis (PD) consist of denudation of peritoneal mesothelial cells, interstitial sclerosis, and hyalinizing vasculopathy. Those changes are considered to be the result of uremia and bioincompatible effects of conventional acidic lactate-buffered dialysate with glucose degradation products (GDPs). In the last decade, biocompatible dialysate with neutral pH and low GDPs has become widely used. Clinical practice has been modified in Japan, especially for anuric patients, and now includes the use of hybrid therapy. The impact on peritoneal morphology has not been well reported. ♦ Objective: The aim of the present study was to investigate the long-term effect on peritoneal morphology and function of biocompatible fluid use and current clinical practice in Japan, including hybrid dialysis therapy. ♦ Methods: We evaluated peritoneal biopsy specimens from patients who had undergone PD for more than 3 years. We used the average peritoneal thickness (APT) of the submesothelial compact zone as a marker of interstitial sclerosis and the lumen/vessel diameter ratio (L/V ratio) at postcapillary venules as a marker of hyalinizing vasculopathy. Demography and other data for the patients, including dialysate-to-plasma (D/P) ratio of creatinine, were obtained at baseline and every 6 months by peritoneal equilibration test.

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“…KEY WORDS: AGEs; angiogenesis; biocompatible solution; GDPs; peritoneal fibrosis; vascular sclerosis. P eritoneal dialysis (PD) solution should not contain bioincompatible elements such as high glucose, low pH, and glucose degradation products (GDPs) (1,2). Those bioincompatible elements promote peritoneal fibrosis, hyalinizing vasculopathy, deposition of advanced glycation end-products (AGEs), and angiogenesis (3,4), which in turn lead to membrane hyperpermeability and reduced ultrafiltration capacity because of the involvement of several factors, including transforming growth factor-β, vascular endothelial growth factor, aquaporin-1, and endothelial nitric oxide synthase (5)(6)(7)(8).…”

Section: Original Articlesmentioning

confidence: 99%

Neutral Solution Low in Glucose Degradation Products is Associated with Less Peritoneal Fibrosis and Vascular Sclerosis in Patients Receiving Peritoneal Dialysis

et al. 2012

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ORIGINAL ARTICLES♦ Background: The effects of novel biocompatible peritoneal dialysis (PD) solutions on human peritoneal membrane pathology have yet to be determined. Quantitative evaluation of human peritoneal biopsy specimens may reveal the effects of the new solutions on peritoneal membrane pathology. ♦ Methods: Peritoneal specimens from 24 PD patients being treated with either acidic solution containing highglucose degradation products [GDPs (n = 12)] or neutral solution with low GDPs (n = 12) were investigated at the end of PD. As controls, pre-PD peritoneal specimens, obtained from 13 patients at PD catheter insertion, were also investigated. The extent of peritoneal fibrosis, vascular sclerosis, and advanced glycation end-product (AGE) accumulation were evaluated by quantitative or semi-quantitative methods. The average densities of CD31-positive vessels and podoplanin-positive lymphatic vessels were also determined. ♦ Results: Peritoneal membrane fibrosis, vascular sclerosis, and AGE accumulation were significantly suppressed in the neutral group compared with the acidic group. The neutral group also showed lower peritoneal equilibration test scores and preserved ultrafiltration volume. The density of blood capillaries, but not of lymphatic capillaries, was significantly increased in the neutral group compared with the acidic and pre-PD groups. ♦ Conclusions: Neutral solutions with low GDPs are associated with less peritoneal membrane fibrosis and vascular sclerosis through suppression of AGE accumulation. However, contrary to expectation, blood capillary density was increased in the neutral group. The altered contents of the new PD solutions modified peritoneal membrane morphology and function in patients undergoing PD.

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Biocompatibility and buffers: Effect of bicarbonate-buffered peritoneal dialysis fluids on peritoneal cell function

Abstract: These results indicate that (i) bicarbonate buffered PDF are less inhibitory to peritoneal cell function as compared to conventional, lactate buffered PDF; and (ii) HPFB may be more resistant than HPMC to bioincompatible PDF.

Cited by 77 publications

References 62 publications

Effect of Hyperosmolality on β-Defensin Gene Expression by Human Corneal Epithelial Cells

Effect of Hyperosmolality on β-Defensin Gene Expression by Human Corneal Epithelial Cells

Peritoneal Morphology after Long-Term Peritoneal Dialysis with Biocompatible Fluid: Recent Clinical Practice in Japan

Neutral Solution Low in Glucose Degradation Products is Associated with Less Peritoneal Fibrosis and Vascular Sclerosis in Patients Receiving Peritoneal Dialysis

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