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Are the Mesothelial-to-Mesenchymal Transition, Sclerotic Peritonitis Syndromes, and Encapsulating Peritoneal

Jesús Loureiro1, Guadalupe Gónzalez-Mateo, José Jimenez-Heffernan

  • 1Centro de Biología Molecular Severo Ochoa, CSIC-UAM, Campus de Cantoblanco, Calle de Nicolás Cabrera 1, 28049 Madrid, Spain.

International Journal of Nephrology
|March 12, 2013
PubMed

Insights

Mesothelial-to-mesenchymal transition (MMT) drives peritoneal fibrosis in peritoneal dialysis (PD). This process, potentially initiating encapsulating peritoneal sclerosis (EPS), highlights MMT

Area of Science:

  • Nephrology
  • Cell Biology
  • Pathology

Background:

  • Mesothelial-to-mesenchymal transition (MMT) is crucial for tissue repair but can cause peritoneal fibrosis under conditions like peritoneal dialysis (PD).
  • Sclerotic peritoneal syndromes (SPS), including encapsulating peritoneal sclerosis (EPS), represent severe peritoneal fibrosis, with EPS being an irreversible complication of PD.
  • The exact pathway from initial fibrosis to advanced EPS remains unclear.

Purpose of the Study:

  • To investigate the role of MMT in the progression of peritoneal fibrosis from SPS to EPS.
  • To establish the link between MMT and the development of irreversible peritoneal damage in PD patients.

Main Methods:

  • Analysis of transdifferentiated mesothelial cells in PD effluent.
  • Examination of peritoneal biopsies from PD patients.
  • Correlation of MMT markers with clinical events and anatomical changes.

Main Results:

  • Transdifferentiated mesothelial cells in PD effluent correlate with clinical events (hemoperitoneum, peritonitis) and PD function.
  • MMT in peritoneal biopsies correlates with fibrosis and angiogenesis.
  • Evidence suggests MMT is present early in fibrosis and persists, potentially initiating the fibrotic process leading to EPS.

Conclusions:

  • MMT is a persistent process present from early stages of peritoneal fibrosis.
  • MMT is implicated as a potential initiator of the fibrotic cascade leading to severe complications like EPS in PD patients.
  • Further research is needed to fully elucidate the MMT pathway in EPS pathogenesis.

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