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Fibronectin and complement secretion by monocytes and peritoneal macrophages in vitro from patients undergoing
Insights
Patients undergoing continuous ambulatory peritoneal dialysis (CAPD) with higher peritonitis rates have lower fibronectin levels in peritoneal fluid. This suggests reduced fibronectin secretion by peritoneal macrophages contributes to increased infection risk in CAPD patients.
Area of Science:
- Nephrology
- Immunology
- Infectious Disease
Background:
- Continuous ambulatory peritoneal dialysis (CAPD) patients are susceptible to peritonitis.
- The role of fibronectin in peritoneal host defense is not fully understood.
Purpose of the Study:
- To investigate the association between fibronectin levels and peritonitis incidence in CAPD patients.
- To examine fibronectin secretion by peritoneal macrophages in CAPD patients with varying infection rates.
Main Methods:
- Measured fibronectin concentration in peritoneal dialysate.
- Assessed in vitro fibronectin secretion by peritoneal macrophages and peripheral blood monocytes.
- Compared these measures between CAPD patients with high and low peritonitis rates and healthy controls.
Main Results:
- CAPD patients with high peritonitis rates had significantly lower dialysate fibronectin concentrations.
- In vitro fibronectin secretion by peritoneal macrophages was reduced in high-infection CAPD patients.
- Plasma fibronectin and monocyte secretion were similar between patient groups but lower than in controls.
Conclusions:
- Decreased fibronectin secretion by peritoneal macrophages is linked to a higher incidence of peritonitis in CAPD patients.
- Fibronectin plays a crucial role in the peritoneal host defense against infection in CAPD.
Abstract:
We investigated the role of the opsonic glycoprotein fibronectin in the host defense of the peritoneum in patients undergoing continuous ambulatory peritoneal dialysis (CAPD). Fibronectin concentration in peritoneal dialysate from high infection rate CAPD patients (greater than 1.50 episodes peritonitis per year) was significantly less than from low infection rate CAPD patients (less than 0.55 episodes peritonitis per year). In vitro secretion of fibronectin by cultured peritoneal macrophages from patients with high infection rate was less than from low infection rate patients (P less than 0.05) and controls (P less than 0.01). In vitro secretion of the second component of complement, however, was similar in both high and low infection rate patients. Plasma fibronectin concentration and in vitro fibronectin secretion by cultured peripheral blood monocytes was not different between high infection rate patients and low infection rate patients, but was less than normals. Decreased fibronectin secretion by peritoneal macrophages is associated with a higher incidence of peritonitis among CAPD patients.
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