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Peritoneal macrophage beta-2 microglobulin production and bacterial peritonitis in CAPD patients
S Carozzi1, G Nasini, C Schelotto
1Nephrology and Dialysis Unit, St. Paul's Hospital, Savona, Italy.
Abstract:
To evaluate the role of bacterial peritonitis in peritoneal macrophage (PM) Beta-2 Microglobulin (B2M) production, and its relationship with PM Interleukin-1 (IL-1) and Leukotriene B4 (LTB4) release, the authors studied 20 CAPD patients (10 with peritonitis): 1. in vivo plasma and peritoneal dialysis effluent (PDE) B2M, IL-1, and LTB4 levels; 2. in vitro B2M, IL-1, and LTB4 release by PM. Values were compared with those seen in the plasma or with peripheral blood monocytes of 30 hemodialysis (HD) patients (10 treated with Cuprophan [CU]; 10 with Polyacrylonitrile [PAN]; and 10 with Cellulose Acetate [CA]). Results showed that in CAPD patients with bacterial peritonitis B2M, IL-1 and LTB4 concentrations in the PDE were significantly higher than those seen in CAPD patients without peritonitis, or in the plasma of HD patients treated with PAN or CA, but were similar to those seen in HD patients treated with CU. At the same time, in vitro PM from CAPD patients with bacterial peritonitis produced more B2M, IL-1, and LTB4, than did PM from CAPD patients without peritonitis, or peripheral blood monocytes from HD patients treated with PAN or CA. The authors conclude that in CAPD patients, bacterial peritonitis is able to induce PM B2M production, probably via a cytokine mediated process, which may be analogous to what occurs with peripheral blood monocytes of HD patients treated with CU.
Insights
Bacterial peritonitis in continuous ambulatory peritoneal dialysis (CAPD) patients significantly increases peritoneal macrophage (PM) production of Beta-2 Microglobulin (B2M), Interleukin-1 (IL-1), and Leukotriene B4 (LTB4). This suggests a cytokine-mediated process during infection.
Area of Science:
- Nephrology
- Immunology
- Peritoneal Dialysis
Background:
- Bacterial peritonitis is a complication in continuous ambulatory peritoneal dialysis (CAPD).
- Peritoneal macrophages (PM) play a role in the inflammatory response.
- Beta-2 Microglobulin (B2M), Interleukin-1 (IL-1), and Leukotriene B4 (LTB4) are inflammatory markers.
Purpose of the Study:
- To investigate the impact of bacterial peritonitis on PM production of B2M, IL-1, and LTB4 in CAPD patients.
- To explore the relationship between these markers and PM release.
- To compare findings with hemodialysis (HD) patients.
Main Methods:
- Studied 20 CAPD patients (10 with peritonitis) and 30 HD patients.
- Measured in vivo plasma and peritoneal dialysis effluent (PDE) levels of B2M, IL-1, and LTB4.
- Assessed in vitro B2M, IL-1, and LTB4 release by PM and peripheral blood monocytes.
Main Results:
- CAPD patients with peritonitis showed significantly higher PDE concentrations of B2M, IL-1, and LTB4 compared to those without peritonitis.
- In vitro PM from peritonitis patients produced higher levels of these markers.
- Elevated levels in CAPD peritonitis patients were comparable to HD patients treated with Cuprophan (CU) membranes.
Conclusions:
- Bacterial peritonitis induces PM B2M production in CAPD patients.
- This induction is likely mediated by cytokines.
- The process may be similar to that observed in HD patients treated with CU membranes.