Inflammation and the Peritoneal Membrane: Causes and Impact on Structure and Function during Peritoneal Dialysis

Baroni, Gilberto; Schuinski, Adriana Fatima Menegat; Moraes, Thyago Proença de; Meyer, Fernando; Pecoits‐Filho, Roberto

doi:10.1155/2012/912595

Cited by 62 publications

(61 citation statements)

References 23 publications

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“…Several factors may contribute to peritoneal local inflammation, such as uremia state, an existing peritoneal catheter, bioincompatible PD solution, and peritonitis [15, 22]. The mesothelium which lines the whole of peritoneal cavity is the principal IL-6-producing cell within the peritoneal cavity and synthesizes large amount of this cytokine upon inflammatory challenge [23].…”

Section: Discussionmentioning

confidence: 99%

High Intraperitoneal Interleukin-6 Levels Predict Peritonitis in Peritoneal Dialysis Patients: A Prospective Cohort Study

et al. 2018

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Background: To evaluate the predictive value of dialysate interleukin-6 (IL-6) representing local subclinical intraperitoneal inflammation for the development of peritonitis in continuous ambulatory peritoneal dialysis (CAPD) patients. Methods: Stable prevalent CAPD patients were enrolled in this prospective study. IL-6 concentration in the overnight effluent was determined and expressed as the IL-6 appearance rate (IL-6AR). Patients were divided into 2 groups according to the median of IL-6AR and prospectively followed up until the first episode of peritonitis, cessation of PD, or the end of the study (December 30, 2017). The utility of IL-6AR in predicting peritonitis-free survival was analyzed using the Kaplan-Meier and Cox proportional hazards models. Results: A total of 149 patients were enrolled, including 72 males (48%) with mean age 52.0 ± 13.6 years and median PD duration 26 (5.9–45.5) months. During follow-up, 7,923 patient months were observed and 154 episodes of peritonitis occurred in 82 patients. Previous peritonitis episodes were significantly associated with log dialysate IL-6AR levels (β = 0.187 [0.022–0.299], p = 0.023). Patients in the high IL-6AR group showed a significantly inferior peritonitis-free survival when compared with their counterparts in the low IL-6AR group (48.8 vs. 67.7 months, p = 0.026), as well as higher treatment failure percentage of peritonitis (20.3 vs. 9.3%, p = 0.049). A multivariate Cox regression showed that high dialysate IL-6AR (hazard ratio [HR] 1.247 [1.052–1.478]; p = 0.011) and high serum C-reactive protein (HR 1.072 [1.005–1.144]; p = 0.036) were independent risk factors for inferior peritonitis-free survival. Conclusion: This prospective study suggested that the intraperitoneal inflammation marker, dialysate IL-6 level, might be a potential predictor of peritonitis development in patients undergoing PD.

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Section: Discussionmentioning

confidence: 99%

High Intraperitoneal Interleukin-6 Levels Predict Peritonitis in Peritoneal Dialysis Patients: A Prospective Cohort Study

et al. 2018

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“…1,7,26 Animal models of EPS are used to define mechanisms, contributing factors and its developmental pathways, and most importantly to elucidate therapeutic strategies and preventive measures. 27,28 In order to produce a model we injected 0.1% CG and 15% ethanol dissolved in saline solution intraperitoneally for three weeks.…”

Section: Discussionmentioning

confidence: 99%

The Effect of Steroid-Sirolimus Combination on the Experimental Model of Encapsulating Peritoneal Sclerosis in Rats

Ersan¹,

Çelik²,

Çelik³

et al. 2015

Turkiye Klinikleri J Nephrol

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A AB BS S T TR RA AC CT T O Ob bj je ec ct ti iv ve e: : Encapsulating peritoneal sclerosis (EPS) is a devastating complication of peritoneal dialysis terminating with peritoneal sclerosis and coccooning of intestinal loops. The inhibitors of mammalian target of rapamycin (mTOR), everolimus and sirolimus, have attenuated EPS findings in experimental animal models. The effect of combination of sirolimus with steroid has not been documented so far. The aim of the study was to determine the effect of combination of sirolimus and steroid on experimental sclerosing peritonitis model. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : 41 wistar albino male rats were divided into 6 groups : control group (C; isotonic saline injected intraperitoneally), chlorhexidine gluconate group (CG; model group), resting group (R; CG then peritoneal rest, prednisolone group (P; CG then prednisolone), sirolimus group (Sir; CG then sirolimus), and prednisolone-sirolimus group (P-Sir; CG then prednisolone plus sirolimus). Peritoneal specimens obtained after sacrification at the end of study were examined for peritoneal thickness, fibrosis, and vascular intensities under light microscopy. R Re es su ul lt ts s: : In the CG and R groups there was a significant increase in peritoneal thickness, fibrosis score and vascular intensity compared to C, P, Sir, and P-Sir groups in both parietal and visceral peritoneum (p<0.05). The parameters at the end of the study were not different in C, P, Sir, and P-Sir groups. The difference between P, Sir, and P-Sir groups were not significant. Resting was shown to be ineffective in attenuating EPS parameters. C Co on nc cl lu us si io on n: : In this study we observed that sirolimus-prednisolone combination was equally effective in experimental EPS model compared to prednisolone and sirolimus only regimens.K Ke ey y W Wo or rd ds s: : Peritonitis; sirolimus; models, animal; adrenal cortex hormones; peritoneal dialysis Ö ÖZ ZE ET T A Am ma aç ç: : Enkapsüle periton sklerozu (EPS), periton sklerozu ve intestinal segmentlerin koza şeklinde sarılması ile sonuçlanan ciddi bir periton diyalizi komplikasyonudur. Memelilerde rapamisin hedefi inhibitörleri (mTOR), everolimus ve sirolimus, deneysel hayvan modellerinde EPS bulgularını azaltmışlardır. Steroid-sirolimus kombinasyonunun etkisine yönelik yapılan bir çalışma bulunmamaktadır. Bu çalışmada deneysel sklerozon peritorit modelinde sirolimus ile steroid kombinasyon tedavisinin etkisini belirlemek amaçlanmıştır. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : 41 wistar albino erkek sıçan 6 gruba ayrıldı: kontrol grubu (C; intraperitoneal izotonik serum), klorheksidin glukonat grubu (CG; model grup), dinlenme grubu (R; CG sonrası periton dinlenme), prednizolon grubu (P; CG sonrası prednizolon), sirolimus grubu (Sir; CG sonrası sirolimus) ve prednizolon-sirolimus grubu (P-Sir; CG sonrası prednizolon ve sirolimus). Periton örnekleri ışık mikroskobisi ile; periton kalınlığı, fibrozis skoru ve damar yoğunluğu için değerlendirildi. B Bu ul lg gu ul l...

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“…Data shows that despite clinical remission, patients with PD still suffer from prolonged systemic chronic inflammation [19]. Injured PMCs and resident macrophages recruit inflammatory cells such as monocytes and lymphocytes, which secrete high levels of pro-inflammatory cytokines that could, in turn, continuously trigger an inflammatory response in the peritoneum [20]. Patients undergoing CAPD have increased levels of pro-inflammatory cytokines, including IL-1β, IL-6, TNF-α, and TGF-β, in both PD effluent and plasma [21].…”

Section: Cell Physiolmentioning

confidence: 99%

The Role of TLR4 in M1 Macrophage-Induced Epithelial-Mesenchymal Transition of Peritoneal Mesothelial Cells

Shi

Sheng

et al. 2016

Cell Physiol Biochem

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Background/Aims: Peritoneal fibrosis is a frequent complication of peritoneal dialysis that follows inflammation. It is recognized that epithelial-mesenchymal transition (EMT) of peritoneal mesothelial cells (PMCs), plays a key role in fibrogenesis. However, the relationship between inflammatory macrophages and PMCs remains elusive. In this study, we investigated the effects of different polarized macrophages on EMT of HMrSV5 PMCs. Methods: Monocytes were polarized to M1/M2 macrophages before being added to HMrSV5 in direct or indirect contact. Morphological changes of HMrSV5 were observed and toll-like receptors 4 (TLR4) on macrophage surfaces was detected using flow cytometry. EMT markers and intracellular signals of HMrSV5 cells were assessed using real time-PCR and WB. Results: The typical epithelial cell morphology of HMrSV5 disappeared after co-culture with M1 macrophages and was accompanied by decreased E-cadherin and increased α-SMA, suggesting HMrSV5 undergo EMT. These effects depended on direct contact between the two cells, as indirect contact or co-culture with M2 macrophages had no effect. Intriguingly, we found TLR4 surface receptors were activated on sorted M1 cells in co-culture, and related signal adaptors, such as TRIF, were obviously upregulated. Conclusion: Direct contact with M1 macrophages induces EMT of PMCs, during which TRIF-dependent TLR4 signaling pathway was activated.

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Inflammation and the Peritoneal Membrane: Causes and Impact on Structure and Function during Peritoneal Dialysis

Cited by 62 publications

References 23 publications

High Intraperitoneal Interleukin-6 Levels Predict Peritonitis in Peritoneal Dialysis Patients: A Prospective Cohort Study

High Intraperitoneal Interleukin-6 Levels Predict Peritonitis in Peritoneal Dialysis Patients: A Prospective Cohort Study

The Effect of Steroid-Sirolimus Combination on the Experimental Model of Encapsulating Peritoneal Sclerosis in Rats

The Role of TLR4 in M1 Macrophage-Induced Epithelial-Mesenchymal Transition of Peritoneal Mesothelial Cells

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