Increased Lymphatic Vessels in Patients with Encapsulating Peritoneal Sclerosis

Abstract

♦ Background: The angiogenic response is partly involved in the progression of encapsulating peritoneal sclerosis (EPS). However, the details of the angiogenic response, especially for lymphatic vessels in patients with EPS, remain unclear. In addition, because of technical limitations, morphology studies reported to date have examined only the parietal peritoneum. The morphologies of parietal and visceral lymphatic vessels in patients with EPS both need to be analyzed. ♦ Methods: We examined peritoneal samples from 18 patients with EPS who underwent enterolysis of the visceral peritoneum and compared them with samples from 17 autopsy cases (controls). To examine the angiogenic response, we performed immunohistochemistry for the endothelial markers CD34 (blood vessels) and podoplanin (lymphatic vessels) and for the cell proliferation marker Ki-67. Immunogold electron microscopy analysis for podoplanin was also performed. In 7 of 18 cases, we compared differences in the angiogenic response of the parietal and visceral peritoneal membranes.

Significance of new membrane formation in peritoneal biopsies of peritoneal dialysis patients: a case–control study

“…There may be some pathophysiological differences between visceral and parietal peritoneum, although they have not been fully established so far. Yaginuma et al demonstrated increased lymphatic vessels in visceral peritoneum rather than parietal peritoneum [26], and this difference might be related to the susceptibility of encapsulating membrane formation in visceral peritoneum via increased exudation. The histological stage may also indicate the consequences of NFMs, that is progression to encapsulation and adhesion or scar formation without the development of EPS.…”

“…This protein is involved in cell motility, migration, and proliferation during development, in the immune system, and in cancer [31]. Because EPS develops in association with increased accumulation of serum and high concentrations of fibrin [17,32], secretion of cytokines and growth factors [26,[33][34][35] may activate the transformation of peritoneal mesenchymal cells into swollen fibroblast-like cells that highly express podoplanin on their cell membranes. Podoplanin-positive fibroblast-like cells in the peritoneum of EPS patients may be activated by platelets and inflammatory cells expressing podoplanin-ligand, CLEC-2 [30], and by the surrounding extracellular matrix containing hyaluronic acid [31].…”

Recommendations for pathological diagnosis on biopsy samples from peritoneal dialysis patients

“…The vascular network of parietal peritoneum is mainly located between the submesothelial interstitial layer and peritoneal adipose tissue and is composed of small artery, arteriole, capillary, post-capillary venule and veins ( Figure 1A-b), occasionally with lymphatic vessels. Of note is that the vascular population varies dependent on age and mesothelial location; blood and lymph vessel density in parietal peritoneum is higher in infant age [17], lymphatic vessels are more abundant in the visceral peritoneum than the parietal [19,25].…”

“…To identify vessels or lymph vessels, cluster of differentiation (CD) 31 (or CD34) and podoplanin staining is added to the procedure [16,17]. Podoplanin staining is also useful to identify mesothelial cells, or podoplanin positive fibroblasts or "fibroblast-like cells (FLC)" [18,19]. Preparation of frozen specimens and electron microscope specimens is recommended when precise investigations are required for special cases or for research purposes.…”

Association Between GLCCI1 Promoter Polymorphism (Rs37972) and Post-Transplant Hypertension in Renal Transplant Recipients

“…These kidney-specimens were stained with anti-GLCCI1 antibody (rabbit primary antibody (pAB), 1:50; Abcam, Cambridge, UK; catalog ab171137), and anti-CD34 antibody, used as specific endothelial marker (rabbit pAB, 1:500; Abcam, Cambridge, UK; catalog ab81289). Immunohistochemical staining was performed as described previously [22]. Reaction products were visualized by staining with 3, 3-diaminobenzidine tetrahydrochloride, before counter-staining sections with Periodic-Acid-Schiff.…”