Effect of lactate as a peritoneal dialysis fluid buffer on rat peritoneal mesothelial cells
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(2020) 6:61
RESEARCH
Open Access
Effect of lactate as a peritoneal dialysis fluid buffer on rat peritoneal mesothelial cells Chieko Higuchi* , Junko Kuriyama and Hiroshi Sakura
Abstract Background: Neutral, low-glucose degradation product (GDP) peritoneal dialysis fluid (PDF) is less damaging to the peritoneum than conventional PDF but is still insufficient for biocompatibility. One remaining issue is the problem of buffering. Methods: Using cultured rat peritoneal mesothelial cells (PMCs), the present study examined the difference between the effects of neutral low-GDP lactate PDF and neutral low-GDP bicarbonate/lactate PDF on cells. The effects of lactate stimulation on these cells were also examined. Results: Lactate PDF enhanced mRNA expressions of α-smooth muscle actin (αSMA) and type 1 and type 3 collagens and lowered expression of e-cadherin mRNA in PMCs compared to bicarbonate/lactate PDF. Lactate stimulation increased mRNA expressions of αSMA, matrix metalloproteinase 2 (MMP2), and basic fibroblast growth factor (bFGF) and suppressed e-cadherin mRNA expression. Transforming growth factor (TGF)-β1 and TGF-β2 and collagen type 1 and 3 mRNA expressions were also enhanced by lactate stimulation. Conclusions: These results suggest that lactate as a PDF buffer may act on PMCs to promote epithelialmesenchymal transition (EMT) and production of TGF-β, bFGF, and collagen. Keywords: Peritoneal dialysis fluid, Buffer, Lactate, Peritoneal mesothelial cell, Epithelial-to-mesenchymal transition, Fibrosis, Transforming growth factor-β, Basic fibroblast growth factor
Background Peritoneal dialysis (PD) is an established treatment in renal replacement therapy, can be performed at home without bulky equipment, and can maintain a high quality of life. However, long-term PD treatment causes pathological changes to the peritoneum, such as detachment of mesothelial cells, fibrosis of the interstitium, increases in the new blood vessels, and narrowing of the vascular cavities [1]. These changes result in peritoneal dysfunction, making PD difficult to maintain. The risk of complications such as encapsulating peritoneal sclerosis due to peritoneal disorders is also increased [2]. To address this problem, a change has been made from acidic high-GDP PDF to
neutral low-GDP PDF, achieving a reduction in rates of peritoneal disorders [3]. However, some problems remain with the biocompatibility of these new PDFs, with the issue of buffering representing one such problem. In Japan, all buffering agents for neutral low-GDP PDF to date have been lactate, but a bicarbonate/lactate buffer PDF has recently been released. However, few studies have examined the effects of buffering agents on the peritoneum. This study investigated the effects of neutral low-GDP PDF containing different buffers on the peritoneum and further clarified the effects of lactate on the peritoneum.
Methods PDF
* Correspondence: [email protected] Department of Medicine, Tokyo Women’s Medical University Medical Center East, 2-1-10 Nishiogu, Arakawa-ku, Tokyo 1
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