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Effect of intraperitoneal immunoglobulin infusion on neutrophil function in CAPD children with and without
1Department of Pediatric Nephrology, Akdeniz University Medical Faculty, Antalya, Turkey.
Insights
Intraperitoneal immunoglobulin (Ig) infusion improved neutrophil function in children on continuous ambulatory peritoneal dialysis (CAPD). This suggests Ig may help prevent or treat peritonitis in CAPD patients.
Area of Science:
- Nephrology
- Immunology
- Pediatrics
Background:
- Neutrophil dysfunction is observed in patients undergoing continuous ambulatory peritoneal dialysis (CAPD).
- Peritonitis is a common complication in CAPD patients, often associated with altered neutrophil function.
Purpose of the Study:
- To evaluate the impact of intraperitoneal immunoglobulin (Ig) infusion on neutrophil functions in children with and without peritonitis undergoing CAPD.
- To determine if Ig administration can enhance neutrophil chemotaxis and chemiluminescence.
Main Methods:
- Blood and peritoneal dialysate effluent (PDE) samples were collected from 14 children on CAPD and 10 healthy controls.
- Neutrophil chemotaxis and chemiluminescence were measured before and after intraperitoneal Ig infusion (100 mg/kg).
- Patient groups were stratified into uninfected and infected (peritonitis) cohorts.
Main Results:
- Peripheral blood neutrophils (PBNs) showed reduced chemotaxis in CAPD patients compared to controls, which improved after Ig infusion.
- Neutrophils from infected patients exhibited higher chemotaxis than those from uninfected patients.
- Intraperitoneal Ig enhanced PBN chemotaxis and chemiluminescence in both groups, though chemiluminescence remained lower than controls.
- Peritoneal neutrophils (PNs) had lower chemotaxis in uninfected patients, with a more pronounced response to Ig in infected patients.
Conclusions:
- Intraperitoneal Ig administration shows potential for prophylaxis and/or treatment of peritonitis in CAPD patients.
- Ig infusion effectively enhances neutrophil functions, particularly in infected CAPD patients.
- Further research is warranted to confirm the therapeutic role of intraperitoneal Ig in CAPD-associated peritonitis.
Abstract:
The present study was designed to assess the effect of intraperitoneal infusion of immunoglobulin (Ig) on neutrophil functions in uninfected and infected patients treated by continuous ambulatory peritoneal dialysis (CAPD). Fourteen children were included in the study. Healthy laboratory and medical personnel (n = 10) served as controls. Blood and peritoneal dialysate effluent (PDE) samples were obtained before and after Ig infusion. In all patients, chemotactic response of peripheral blood neutrophils (PBN) was significantly lower than in healthy controls. Peripheral blood neutrophils obtained from patients during peritonitis episodes (n = 10) showed significantly higher values compared to the values obtained from patients without peritonitis (n = 12). After the intraperitoneal infusion of Ig (100 mg/kg), chemotaxis of PBNs increased significantly in both patient groups. Chemiluminescence measures of PBN of the uninfected (n = 12) and infected patients (n = 7) were similar. They increased significantly in both groups after the Ig infusion, although they remained within the lower limits of the controls. The peritoneal neutrophils (PNs) showed significantly lower chemotactic activity in uninfected patients (n = 11) than in the infected ones (n = 10). The response of PNs to the Ig infusion was also more prominent in infected patients. Immunoglobulin infusion did not increase the chemiluminescence of PNs in infected patients (n = 7); the chemoluminescence of PNs did increase after Ig infusion in uninfected patients (n = 12). These data suggest the of administration intraperitoneal Ig for prophylaxis and/or treatment of peritonitis in CAPD patients.