Peritoneal dialysis solution biocompatibility: inhibitory mechanisms and recent studies with bicarbonate-buffered solutions.
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Bicarbonates↗
Biomedical subjects
N Topley
Publications and source records attributed to N Topley.
Mucosal immunity in the urinary tract: changes in sIgA, FSC and total IgA with age and in urinary tract infection.
The incidence of primary urinary tract infection (UTI) is greatest in the first month of life and decreases with age throughout childhood. Secretory immunoglobulin A (sIgA) is an important component of mucosal immunity. The changes in secretory IgA, IgA and free secretory component (FSC) during the first year of life were examined in relation to age, sex and in infants, feeding practice. These constituents were further compared between healthy children and those with acute and recurrent UTI. Urine was collected from 41 healthy infants (16 female: 25 male) at intervals (mean age 1.4, 9.1, 44, 91, 210 and 412 days), 139 healthy children (75 female: 64 male), 29 children with histories of recurrent UTI (25 female: 4 male) and 10 with acute UTI (8 female: 2 male). sIgA, IgA and FSC were measured by enzyme linked immunoassay. In the majority of children sIgA and IgA were undetectable at birth. SIgA and IgA rose significantly during the first year then levelled off throughout childhood. FSC was detectable from birth (geometric mean [mean of logged values]-GOM at day 1.4, 362.2 ng/ml). No sex differences were apparent for any of the three constituents at any age. Breast feeding was associated with higher levels of sIgA and IgA than bottle feeding. This was highly significant at 9.1 days when sIgA and IgA levels of breast fed compared with bottle fed infants were 64.6 ng/ml vs 21.2 and 56.2 ng/ml vs 18.7 ng/ml respectively, giving a GOM ratio of 3.04 for sIgA and 3.0 for IgA (p < 0.001 for both). No significant difference in the three parameters were demonstrable when children with recurrent UTI-with normal or abnormal renal tracts-were compared with controls. Acute UTI resulted in raised sIgA, IgA and FSC compared with controls (GOM ratio of 4.9 [p < 0.002], 4.2 [p < 0.005] and 2.7 [p < 0.001] respectively). The proportion of total IgA present as sIgA (sIgA/total IgA) was not significantly different in the acute vs control groups. Urinary sIgA and IgA may be important for the observed variation with age in infant UTI and the reduced incidence in breast fed infants but does not appear to contribute to the sex associated difference in susceptibility to infection at any age.
Acute Disease↗
Macrophages and mesothelial cells in bacterial peritonitis.
Research in recent years has examined the mechanisms underlying cellular host defence in the peritoneal cavity. These studies have established that the resident cells of the peritoneal cavity, the peritoneal macrophages (PM phi) and the mesothelial cells (HPMC) contribute to the initiation, amplification and resolution of peritoneal inflammation. Ex vivo measurements of intra-peritoneal inflammatory mediators during peritonitis has elucidated the time courses for the generation of proinflammatory, chemotactic and anti-inflammatory cytokines and have identified that their secretion occurs largely within the peritoneum. These studies provide evidence that both PM phi- and HPMC-derived mediators are directly involved in controlling inflammation. It has been widely accepted that resident PM phi form the first line of defence against peritoneal infection, a more contemporary view would suggest that the direct or indirect (via secreted pro-inflammatory cytokines) interaction between PM phi and HPMC is pivotal to the activation and subsequent amplification of the peritoneum's response to infection. Whilst the site of these interactions is unknown, considerable evidence suggests that it occurs on the surface of the mesothelium, where invading micro-organisms may colonize. In this respect Staphylococcal exoproducts can directly activate HPMC cytokine synthesis. Once the inflammatory response is initiated, recent evidence suggests, that mesothelial cells upon activation by PM phi-derived IL-1 beta and TNF-alpha, are capable of amplifying inflammation and generating signals (via the creation of a gradient of chemotactic cytokines, IL-8, MCP-1 and RANTES) for the recruitment of leukocytes into the peritoneum. This process is also facilitated via the cytokine driven up-regulation of adhesion molecule expression (ICAM-1 and VCAM-1) on HPMC. Much less is understood about the mechanisms by which inflammation is resolved, although the secretion of anti-inflammatory molecules (IL-6, IL-1ra and soluble TNF-p55/75) by receptors by PM phi and HPMC may be important in the process. The existence of a peritoneal cytokine network controlling inflammation is now well established, within this the interaction of PM phi and HPMC appears to play a pivotal role in the hosts response to peritoneal infection.
Animals↗
Biocompatibility of peritoneal dialysis solutions and host defense.
The relationship of peritoneal dialysis fluid and biocompatibility in peritoneal host defense is an area of great importance in clinical practice. This article reviews current biocompatibility research and examines the relationship of biocompatibility to peritoneal host defense and susceptibility to infection.
Biocompatible Materials↗
Biocompatibility of bicarbonate buffered peritoneal dialysis fluids: influence on mesothelial cell and neutrophil function.
The present study compares the effects of lactate and bicarbonate buffered PDF on human neutrophil (PMN) and human peritoneal mesothelial cell (HPMC) viability and function. Acute exposure of PMN to lactate buffered PDF at pH 5.5 (CAPD 2, 1.5% and CAPD 3, 4.25% glucose) resulted in significant reductions in cellular ATP levels, the phagocytosis of serum treated zymosan (STZ) and respiratory burst activation (CL). Exposure of PMN to bicarbonate buffered PDF (BIC 20, 1.5% glucose and BIC 30, 4.25% glucose both at pH 7.2) had no significant effect on cell viability or the CL response. Phagocytosis was, however, depressed significantly more following exposure to BIC 30 than BIC 20. PMN cellular ATP levels and phagocytosis were significantly better in cells exposed to BIC 30 than to CAPD 3 at pH 7.4 (P = 0.043 for both). Pre-exposure of HPMC to CAPD 2, CAPD 3 or BIC 30 for 30 minutes resulted in a significant reduction in cellular ATP content compared to control medium. Pre-exposure to BIC 20 did not result in a reduction in HPMC ATP levels. HPMC synthesis of IL-6 was unaffected by 15 or 30 minutes pre-exposure to BIC 20 or BIC 30, in contrast pre-exposure to CAPD 2 or CAPD 3 for 15 or 30 minutes resulted in a significant reduction in stimulated IL-6 synthesis (24.5 +/- 3.01 and 32.3 +/- 5.0 vs. 43.9 +/- 10 pg/microgram cell protein in M199, N = 6; P = 0.02). Neutralization of the pH of CAPD 2 and CAPD 3 resulted in normalization of HPMC IL-6 secretion. Analysis of IL-6 mRNA expression in control, BIC 20 and 30 pre-treated HPMC subsequently stimulated with IL-1 beta revealed no differences in the expression of the IL-6 specific 465 base pair transcripts. The improved cellular function in bicarbonate buffered PDF indicates potentially improved host defence status and preservation of the peritoneal membrane in CAPD patients.
Adenosine Triphosphate↗
Superinduction of IL-6 synthesis in human peritoneal mesothelial cells is related to the induction and stabilization of IL-6 mRNA.
The initiation of peritonitis is accompanied by a massive increase in intraperitoneal levels of IL-6. The source of this cytokine and the mechanism by which its levels are increased so dramatically are unknown. We examined the mechanism of IL-6 secretion by HPMC exposed to the milicu present in the peritoneal cavity during the initiation of inflammation. Exposure of HPMC to spent peritoneal dialysis effluent (PDE) or IL-1 beta resulted in a time- and dose-dependent increase in IL-6 secretion. After 24 hours the IL-6 release (pg/microgram cell protein) was increased from 5.0 +/- 0.8 in control cells to 16.0 +/- 2.4 and to 83.8 +/- 17.4 in HPMC treated with PDE and IL-1 beta (1000 pg/ml), respectively (N = 5, P < 0.05). If, however, PDE and IL-1 beta were combined, then the secretion of IL-6 was synergistically increased to 747.7 +/- 349.9 (P < 0.05 vs. expected additive value). The same effect was evident when PDE was combined with TNF alpha or mixed with peritoneal macrophage conditioned medium. These changes were not a reflection of HPMC proliferation as estimated by 3H-thymidine incorporation. The "superinduction" of IL-6 release was associated both with the induction and stabilization of IL-6 mRNA. Competitive PCR demonstrated that the amount of IL-6 mRNA (fM/microgram total RNA) was increased from 0.35 +/- 0.13 in control cells to 11.66 +/- 3.89 and to 10.83 +/- 5.17 in HPMC treated with PDE and IL-1 beta (100 pg/ml), respectively (N = 5, P < 0.05). The combination of PDE + IL-1 beta synergistically increased IL-6 mRNA levels to 56.33 +/- 8.79 (P < 0.05 vs. additive value). RNA stability experiments using actinomycin D revealed that the half life of IL-6 mRNA (hours) was increased from 2.8 hours in control cells to 6.7 and 9.4 in HPMC exposed to PDE and IL-1 beta, respectively. The combination of PDE together with IL-1 beta resulted in a prolonged stabilization of IL-6 mRNA with levels remaining constant over the 12 hours of the experiment. These data demonstrate that HPMC IL-6 synthesis can be synergistically amplified in the presence of peritoneal dialysis effluent and PMO-derived cytokines. The results suggest that the peritoneal mesothelium may be responsible for the dramatic rise in IL-6 levels seen during the initial stages of CAPD peritonitis.
Cell Division↗
Induction of TGF-beta 1 synthesis in D-glucose primed human proximal tubular cells by IL-1 beta and TNF alpha.
The aim of the present study was to examine whether the induction of TGF-beta 1 synthesis by the pro-inflammatory macrophage derived cytokines, IL-1 beta or TNF alpha, was modified by alterations in D-glucose concentrations. Stimulation of growth arrested HPTC with IL-1 beta or TNF alpha resulted in increased expression of TGF-beta 1 mRNA. The transcript was demonstrable 60 minutes after the addition of IL-1 beta, and apparent steady-state mRNA levels were achieved after six hours. Following stimulation with TNF alpha, TGF-beta 1 mRNA was detectable after 15 minutes and reached steady state levels by two hours. Quantitative RT-PCR revealed that following six hours stimulation with either IL-1 beta or TNF alpha (both at 1 ng/ml), there was no difference in the absolute amount of TGF-beta 1 mRNA induced by these two stimuli (14.8 +/- 5.6 vs. 19.7 +/- 4.9 PM). Despite induction of TGF-beta 1 mRNA following stimulation with IL-1 beta or TNF alpha, neither stimulus increased TGF-beta 1 protein synthesis or release. Pre-exposure of HPTC to 25 mM D-glucose for 48 hours and subsequent stimulation with IL-1 beta resulted in the secretion of latent TGF-beta 1 in both a time and dose dependent manner. This effect was not apparent following TNF alpha stimulation of D-glucose primed HPTC. Stimulation of TGF-beta 1 synthesis by IL-1 beta in D-glucose primed cells was inhibited by cycloheximide but not by actinomycin-D. Examination of D-glucose induced TGF-beta 1 mRNA revealed that IL-1 beta, but not TNF alpha, increased the stability of the D-glucose induced transcript. These results demonstrate that the interaction of D-glucose and IL-1 beta lead to secretion of TGF-beta 1 by HPTC. In contrast, such an interaction was not demonstrable between D-glucose and TNF alpha. This may be explained by the ability of IL-1 beta to stabilize D-glucose-induced TGF-beta 1 mRNA.
Cells, Cultured↗
Longitudinal evaluation of peritoneal macrophage function and activation during CAPD: maturity, cytokine synthesis and arachidonic acid metabolism.
The release of cytokines and prostaglandins (PG) by peritoneal macrophages (PM luminal diameter of) may influence the cytokine network controlling peritoneal inflammation and in the long-term the function of the peritoneum as a dialysis membrane. In the present study, an evaluation of the long-term effects of peritoneal dialysis on the release of cytokines and prostaglandins, and the expression of surface markers of cellular maturation on blood and mononuclear cells has been performed in patients during their first year on CAPD. Spontaneous release of tumour necrosis factor alpha (TNF alpha) and interleukins 6 (IL-6) by PM luminal diameter of, after 4 or 24 hours in culture, increased significantly with time on CAPD, while there was a small but significant decrease in release of prostaglandin E2 (PGE2). Production of TNF alpha and IL-6 was enhanced following incubation of the cells with lipopolysaccharide (LPS), but the effect of LPS was proportionally greater on blood monocytes than on PM luminal diameter of. There was a significant increase in the concentrations of PGE2 and 6-keto-prostaglandin F1 alpha in overnight dwell peritoneal dialysis effluent with time on CAPD. The levels of TNF alpha and IL-6 in uninfected PDE were below the detection limit of the immunoassay over the whole time period studied. Expression of CD15, which correlates with immaturity, by PM luminal diameter of and blood monocytes increased with time on CAPD, while expression of CD11c, a marker of maturation, decreased on blood monocytes, but did not change significantly on PM luminal diameter of. There was also a slight increase in expression of transferrin receptor in both PM luminal diameter of and monocytes, but this did not reach statistical significance. These findings suggest that peritoneal macrophages and blood monocytes isolated from CAPD patients over a one year period become increasingly immature with time, and this is accompanied by a significant modulation of their ability to secrete inflammatory cytokines. Dysregulation of macrophage function may have important consequences with respect to inflammatory processes and the long-term function of the peritoneal membrane in CAPD patients.
Adolescent↗
Effect of peritoneal dialysis on cytokine production by peritoneal cells.
Over the past few years it has become increasingly clear that the peritoneal membrane contributes significantly to inflammatory processes occurring in the peritoneal cavity. The increasing use of continuous ambulatory peritoneal dialysis has focused attention of both the role of the mesothelium in peritoneal host defence as well as assessing the importance of the infusion of dialysis fluids on modulation of peritoneal cell function. The current review will examine our increasing knowledge of the peritoneal host defense mechanisms, particularly the involvement of the peritoneal membrane, and the mesothelium in particular, and its interaction with peritoneal macrophages. We will discuss our present knowledge of how cell viability and the secretion of inflammatory and regulatory mediators (cytokines) by the mesothelial cells are modulated following exposure to peritoneal dialysis fluid in vitro and in vivo.
Cell Division↗
Establishment and functional characterization of human peritoneal fibroblasts in culture: regulation of interleukin-6 production by proinflammatory cytokines.
The functional and morphologic integrity of the peritoneal membrane is of major importance for the successful treatment of patients with chronic peritoneal dialysis. This study aimed at the establishment and functional characterization of human peritoneal fibroblasts (HPFB) in cell culture. HPFB were isolated from human omentum by enzymatic digestion and cultured. Confluent HPFB could be identified as spindle-shaped cells, growing in parallel arrays and whorls which stained positive for vimentin and negative for factor VIII, cytokeratin 18, and desmin. Maximum cell growth was observed after 24 h in medium supplemented with 10% fetal calf serum. HPFB could be growth arrested and maintained in fetal calf serum-depleted medium (0.1%) for > 48 h without loss of cell viability as evaluated by intracellular ATP determination. Stimulation of resting HPFB for 0.5 to 48 h with increasing doses of interleukin (IL)-1 beta and/or tumor necrosis factor-alpha (1 to 10,000 pg/mL) resulted in a dose- and time-dependent induction of IL-6 messenger RNA and an increase in immunoreactive IL-6 protein secreted into HPFB supernatants, which was significant with IL-1 beta or tumor necrosis factor-alpha doses as low as 1 pg/mL. HPFB IL-6 production could be inhibited by both actinomycin D or cycloheximide, which suggests that the induction of IL-6 occurs both on a transcriptional and a post-transcriptional level. In summary, this cell culture model is expected to facilitate further investigation of the potential role of the HPFB in the peritoneal cytokine network of patients treated with chronic peritoneal dialysis.
Cell Cycle↗
Adherence of neutrophils to human peritoneal mesothelial cells: role of intercellular adhesion molecule-1.
Peritonitis is accompanied by a massive influx of polymorphonuclear leukocytes (PMN) into the peritoneal cavity, little is known, however, about the process of neutrophil transmigration across the peritoneal membrane. The study presented here, therefore, investigates the adherence of human PMN to human peritoneal mesothelial cell monolayers and examines the importance of intercellular adhesion molecule-1 (ICAM-1) in the process. Human peritoneal mesothelial cells (HPMC) constitutively expressed ICAM-1 protein and mRNA. Stimulation with IL-1 beta or TNF alpha resulted in time- and dose-dependent upregulation of ICAM-1 mRNA transcript and increased cell-surface immunoreactive protein expression. Peak surface expression of ICAM-1 occurred between 12 and 24 h after cytokine stimulation when the level of expression was increased by on average threefold above control. The adherence of PMN to HPMC after stimulation with either IL-1 beta or TNF alpha was both dose- and time-dependent. Peaks of PMN binding to HPMC occurred at 2 and 12 h after stimulation. After 12 h, the number of PMN binding to HPMC increased from 71.3 +/- 12.5 in control cells to 180 +/- 36.5 and 125 +/- 23.6 (x 10(3) PMN), after IL-1 beta (100 pg/mL) and TNF alpha (1000 pg/mL), respectively (z = 2.52 and 2.38, N = 6, P < 0.02 versus control for both). The roles of HPMC ICAM-1 and the PMN counter receptor LFA-1 (CD11a/CD18) in the adherence of PMN to HPMC were confirmed by using anti-CAM Fab2' fragments, and anti-integrin antibodies, all of which significantly reduced the adherence of PMN to both control and cytokine-treated HPMC. These data suggest that ICAM-1 expression by HPMC may be one mechanism by which neutrophils adhere to the mesothelium during their transmigration into the inflamed peritoneal cavity.
Antigens, CD↗
In vitro effects of bicarbonate and bicarbonate-lactate buffered peritoneal dialysis solutions on mesothelial and neutrophil function.
The inclusion of bicarbonate in the formulation of peritoneal dialysis solutions may avoid the in vitro impairment of certain cell functions seen with acidic lactate-based fluids. The supranormal physiological levels of HCO3- and PCO2 inherent in such formulations may, however, not be biocompatible. This study compared the in vitro biocompatibility of a pH 5.2 lactate-based formulation with formulations containing either 40 mM lactate at pH 7.4, 38 mM HCO3- at pH 6.8 (PCO2 at approximately 240 mm Hg) or 7.4 (PCO2 at approximately 60 mm Hg), and 25 mM HCO3- plus 15 mM lactate at pH 6.8 (PCO2 at approximately 160 mm Hg) or 7.4 (PCO2 at approximately 40 mm Hg). Significant release of lactate dehydrogenase or decreases in ATP content by human peritoneal mesothelial cells (HPMC) and human peripheral polymorphonuclear leukocytes (PMN) after a 30-min exposure to each test solution was only seen with the pH 5.2 lactate-based fluid. The ATP content of HPMC exposed to this fluid returned to control levels after 30 min of recovery in M199 control medium but showed a trend toward decreasing ATP content at 240 min. Similarly, interleukin (IL)-1 beta-induced IL-6 synthesis by HPMC was also only significantly reduced by the pH 5.2 lactate solution. PMN chemiluminescence was unaffected by 30-min exposure to all test solutions except for the pH 5.2 lactate formulation. Staphylococcus epidermidis phagocytosis was reduced to between 46 to 57% of control with all test solutions except the pH 5.2 lactate solution, which further suppressed the chemiluminescence response to 17% of control. These data suggest that short exposure to supranormal physiological levels of HCO3- and PCO2 does not impair HPMC or PMN viability and function. Furthermore, neutral pH lactate-containing solutions show equivalent biocompatibility to bicarbonate-based ones.
Adenosine Triphosphate↗
Activation of inflammation and leukocyte recruitment into the peritoneal cavity.
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Animals↗
Effect of lactate-buffered peritoneal dialysis fluids on human peritoneal mesothelial cell interleukin-6 and prostaglandin synthesis.
The present study focused on the evaluation of constitutive and cytokine-stimulated human peritoneal mesothelial cell (HPMC) IL-6 and 6-keto-PGF1 alpha release following pre-exposure to peritoneal dialysis fluid (PDF). Exposure of HPMC to PDF pH 5.2 resulted in a time-dependent increase in cell cytotoxicity [as assessed by lactate dehydrogenase (LDH) release] and concomitant inhibition of constitutive and IL-1 beta stimulated IL-6 and 6-keto-PGF1 alpha synthesis. After 15 minutes of exposure to PDF constitutive and IL-1 beta stimulated IL-6 release were reduced by 32.0 +/- 9.7% and 76.0 +/- 7.4% (N = 6, P < 0.046 and P < 0.027, respectively). PCR amplification of reverse transcribed mRNA from HPMC pre-exposed to PDF pH 5.2 demonstrated suppression of IL-1 beta stimulated IL-6 and cyclooxygenase (Cox-1 and Cox-2) transcripts. In order to mimic the dialysis cycle in vivo, an in vitro dialysis system was established. HPMC were exposed first to control medium, PDF pH 5.2 or PDF 7.3 for 15 minutes and then sequentially to pooled spent peritoneal dialysis effluent for up to four hours. The cells were subsequently allowed to recover in control medium for 12 hours in the presence or absence of IL-1 beta or TNF-alpha (both at 1000 pg/ml). There was no evidence of significant cell toxicity as assessed by LDH release during either the 'in vitro dialysis' or 'recovery' phases. Under these conditions short term exposure to PDF pH 5.2 followed by 'in vitro dialysis' resulted in significant inhibition of cytokine stimulated IL-6 (69.6 +/- 18.2 vs. 96.7 +/- 27.9 pg/microgram, N = 13; P < 0.020 for IL-1 beta) and 6-keto-PGF1 alpha (197.5 +/- 89.2 vs. 289.6 +/- 114.5 pg/microgram, N = 13; P < 0.020 for IL-1 beta) and 6-keto-PGF1 alpha (197.5 +/- 89.2 vs. 289.6 +/- 114.5 pg/microgram, N = 13; P < 0.003) release when compared to cells incubated in control medium. Adjustment of the pH of PDF to 7.3 reversed its inhibitory effects. We conclude that short-term exposure to PDF pH 5.2 significantly inhibits HPMC cytokine and prostaglandin release, an effect which appears to be related to its initial pH. Repeated exposure to nonphysiological PDF might impair mesothelial cell function and thus modulate intraperitoneal inflammatory processes.
6-Ketoprostaglandin F1 alpha↗
The expression of NADPH oxidase components in human glomerular mesangial cells: detection of protein and mRNA for p47phox, p67phox, and p22phox.
Previous work has shown that human mesangial cells (HMC) are capable of low rates of generation of reactive oxygen species for considerable periods of time. In this communication, the presence of components of an NADPH oxidase-like system, more commonly associated with phagocytic leukocytes, is shown. The ability of HMC to generate low levels of superoxide may have important implications in cellular signaling in general and may contribute to glomerular injury. Spectroscopic analysis of HMC membranes revealed a low-potential cytochrome b component, redox midpoint potential centered around -250 mV, which is present at 60 pmol/mg of membrane protein. Immunodetection studies suggested the presence of the p22phox, p47phox, and p67phox components of the NADPH oxidase, whereas the gp91phox was not detected. Further studies with oligonucleotide polymerase chain reaction primers showed that, in HMC the mRNA expression of the p67phox and p47phox was absent from growth-arrested cells but was present in HMC treated with interleukin-1 beta (1,000 pg/mL), whereas gp91phox could not be detected. Only mRNA corresponding to p22phox was present in growth-arrested cells; p47phox mRNA was induced by 2-h treatment with interleukin-1 beta but declined after 6-h treatment. These data illustrate for the first time that HMC are capable of expressing mRNA for several NADPH oxidase components. The apparent absence, or variation, of the gp91phox indicates the likelihood of an NADPH oxidase isoenzyme.
Base Sequence↗
The host's initial response to peritoneal infection: the pivotal role of the mesothelial cell.
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Cytokines↗
Elevated D-glucose concentrations modulate TGF-beta 1 synthesis by human cultured renal proximal tubular cells. The permissive role of platelet-derived growth factor.
Interstitial fibrosis is a marker of progression of renal impairment in diabetic nephropathy. Transforming growth factor (TGF)-beta 1 is one of a group of pro-fibrotic cytokines and growth factors that have been associated with the development of interstitial fibrosis. We have examined the modulating influence of glucose on the production of TGF-beta 1 by cultured human proximal tubular cells. Incubation of growth-arrested human proximal tubular cells (HPTC) (72 hours in serum free medium) in 25 mmol/L D-glucose resulted in increased expression of TGF-beta 1 mRNA (as assessed by reverse transcription polymerase chain reaction). This was apparent after 6 hours and increased up to 120 hours exposure. TGF-beta 1 secretion, however, as measured by specific enzyme-linked immunoassay, was unaffected by exposure to 25 mmol/L D-glucose. Sequential stimulation of HPTC, first with 25 mmol/L D-glucose for 48 hours and then with platelet-derived growth factor (PDGF) isoforms, resulted in a dose-dependent secretion of TGF-beta 1. Pre-exposure to 5 mmol/L D-glucose or 25 mmol/L L-glucose did not prime for TGF-beta 1 release. At 50 ng/ml PDGF this effect was greatest for the AA isoform (AA 31.4 +/- 7.1, AB 20.98 +/- 8.9, BB 7.8 +/- 2.2, P < 0.05 for all versus control, n = 3, mean +/- SEM ng/10(6) cells/24 hours). These effects were blocked by the addition of antibody to the PDGF alpha-receptor. TGF-beta 1 secretion was inhibited in a dose-dependent manner by pretreatment with cyclohexamide, but was not affected by pretreatment with actinomycin D. Stimulation of HPTC with a single dose of PDGF induced TGF-beta 1 mRNA; however, only after application of a second dose of PDGF (after TGF-beta 1 mRNA induction) did TGF-beta 1 protein secretion occur. We also demonstrated that PDGF stimulation of HPTC induced an inherently more stable TGF-beta 1 mRNA transcript. These findings demonstrate that elevated D-glucose concentration alone is insufficient to lead to increased TGF-beta 1 secretion by HPTC despite increased mRNA expression. However, application of a second stimulus such as PDGF, when TGF-beta 1 mRNA expression is increased, leads to increased protein synthesis and secretion of TGF-beta 1. This implies that elevated glucose concentrations might prime proximal tubular cells for TGF-beta 1 synthesis and thus contribute to the development of interstitial fibrosis.
Base Sequence↗
The cytokine network controlling peritoneal inflammation.
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Animals↗