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Peritoneal dialysis solution pH and Ca2+ concentration regulate peritoneal macrophage and mesothelial cell activation
S Carozzi1, P M Caviglia, M G Nasini
1Nephrology and Dialysis Unit, St. Paul's Hospital, Savona, Italy.
ASAIO Journal (American Society for Artificial Internal Organs : 1992)
|January 1, 1994
Summary
Peritoneal dialysis solution (PDS) pH and calcium affect immune cell responses. Acidic, high-calcium PDS increased cytokine release, while acidic, low-calcium PDS decreased it, impacting peritoneal dialysis patient outcomes.
Area of Science:
- Nephrology
- Immunology
- Biochemistry
Background:
- Peritoneal dialysis solutions (PDS) are crucial for managing kidney failure.
- The composition of PDS, specifically pH and calcium (Ca2+) concentration, may influence peritoneal immune cell function.
- Understanding these effects is vital for optimizing PDS formulations and patient outcomes.
Purpose of the Study:
- To investigate the in vitro effects of varying pH and Ca2+ concentrations in PDS on immune mediators.
- To assess the impact on cytokine release (IL-1, TNF-alpha, IL-6, IL-8) from peritoneal macrophages (PM0) and mesothelial cells (PMC).
- To determine changes in intracellular Ca2+ concentrations within PM0 and PMC.
Main Methods:
- PM0 and PMC were incubated with four different PDS formulations varying in pH (acidic vs. bicarbonate-buffered) and Ca2+ concentration (1.25 mM vs. 1.75 mM).
- Cells were stimulated with Staphylococcus epidermidis.
- Cytokine release and intracellular Ca2+ levels were measured.
Main Results:
- Acidic PDS with high Ca2+ (Type A) increased PM0 and PMC cytoplasmic Ca2+ and cytokine release by ~60%.
- Acidic PDS with low Ca2+ (Type B) decreased PM0 and PMC cytoplasmic Ca2+ and cytokine release by ~90%.
- Bicarbonate-buffered PDS with high Ca2+ (Type C) increased IL-1 and TNF-alpha release from PM0, with elevated intracellular Ca2+.
- Bicarbonate-buffered PDS with low Ca2+ (Type D) decreased PM0 and PMC cytoplasmic Ca2+ and cytokine release by ~40%.
Conclusions:
- PDS pH and Ca2+ concentration significantly modulate peritoneal immune cell responses in vitro.
- Acidic PDS formulations can have opposing effects on cytokine release depending on Ca2+ levels.
- Bicarbonate-buffered PDS may alter specific inflammatory pathways and calcium signaling.