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Decreased size of peritoneal macrophage during peritonitis in continuous ambulatory peritoneal dialysis patients
W T Chen1, Y Kobayashi, T P Huang
1Department of Pediatrics, Osaka University, School of Medicine, Japan.
Abstract:
From January 1987 to July 1988, 30 patients suffering from end-stage renal disease were treated with continuous ambulatory peritonitis dialysis (CAPD) therapy. Serial cell number, size and cycle of the peritoneal macrophage (PM) in these patients were measured before and during episodes of peritonitis from the time they started CAPD therapy. Patients with peritonitis were divided into high peritonitis occurrence (HPOG) and low peritonitis occurrence (LPOG) groups. Both before and during occurrence of peritonitis, there were no significant differences in the number of PM cells in the dialysate taken from patients in the HPOG and LPOG. When peritonitis occurred, the size and cell cycle S/Go-G1 ratio decreased about 3 days after the onset of peritonitis. It progressed to the lowest level 7-10 days later, then progressively recovered. However, the dialysate PM cells from the HPOG took a much longer time to recover to the preperitonitis size. When dialysate PM cells from patients without peritonitis were put into the dialysate of HPOG patients on day 10 of peritonitis and incubated for 24 h, an obvious decrease in cell size could be identified. On the other hand, when the PM cells from HPOG patients with peritonitis on day 10 were incubated 24 h with the dialysate from patients without peritonitis, there were obvious increases in cell size. These results suggest there may be a substance (or substances) in the peritonitis dialysate, which contribute(s) to the shrinkage of PM cell size.
Insights
Peritonitis during continuous ambulatory peritonitis dialysis (CAPD) therapy shrinks peritoneal macrophage (PM) cell size. Dialysate from peritonitis patients may contain substances causing this PM cell shrinkage, especially in high peritonitis occurrence (HPOG) patients.
Area of Science:
- Nephrology
- Immunology
- Cell Biology
Background:
- Continuous ambulatory peritonitis dialysis (CAPD) is a treatment for end-stage renal disease.
- Peritonitis is a common complication of CAPD therapy.
- Peritoneal macrophages (PMs) play a role in the immune response within the peritoneal cavity during CAPD.
Purpose of the Study:
- To investigate the changes in peritoneal macrophage (PM) cell number, size, and cell cycle during and after peritonitis in CAPD patients.
- To compare PM characteristics between patients with high peritonitis occurrence (HPOG) and low peritonitis occurrence (LPOG).
- To explore the potential role of the peritoneal dialysate in modulating PM size during peritonitis.
Main Methods:
- Serial measurements of PM cell number, size, and cell cycle (S/Go-G1 ratio) in dialysate from 30 CAPD patients before and during peritonitis.
- Categorization of patients into HPOG and LPOG groups based on peritonitis frequency.
- In vitro incubation experiments using PMs and dialysate from both peritonitis and non-peritonitis patients.
Main Results:
- No significant difference in PM cell number between HPOG and LPOG groups, before or during peritonitis.
- Peritonitis onset led to a decrease in PM size and cell cycle S/Go-G1 ratio, with recovery taking longer in HPOG patients.
- Incubation of non-peritonitis PMs with peritonitis dialysate caused cell shrinkage, while incubation of peritonitis PMs with non-peritonitis dialysate increased cell size.
Conclusions:
- Peritoneal dialysate during peritonitis may contain factors that induce PM cell shrinkage.
- The observed changes in PM size and delayed recovery in HPOG patients suggest a potential mechanism contributing to recurrent peritonitis.
- Further research is warranted to identify the specific substances in the dialysate responsible for PM size modulation.