Feasibility of mesothelial transplantation during experimental peritoneal dialysis and peritonitis

The mesothelial cell layer lining the peritoneum orchestrates peritoneal homeostasis. Continuous exposure to peritoneal dialysis fluids and episodes of peritonitis may damage the monolayer irreversibly, eventually leading to adhesion formation and fibrosis/sclerosis of the peritoneum. Autologous mesothelial cell transplantation is thought to be one of the options to reduce dysfunction of the peritoneal membrane. In this article we will review the mesothelial cell transplantation experiments performed in the field of peritoneal dialysis and peritonitis. In addition we will focus on the trouble shooting using cultured autologous mesothelial cells for transplantation.     

半胱氨酸蛋白酶抑制剂C对脑缺血再灌注大鼠Bcl-2、Bax和Beclin-1的表达及细胞凋亡的影响

目的:应用不同浓度的半胱氨酸蛋白酶抑制剂C(cystatin C,Cys C)干预脑缺血再灌注大鼠,检测Bcl-2、Bax、Beclin-1阳性细胞的表达,探讨自噬蛋白Beclin-1与凋亡之间的关系。方法:成年雄性SD大鼠随机分成假手术组(Sham组),缺血再灌注组(I/R组),Cys C低、中、高浓度组。用线栓法制备大鼠右侧大脑中动脉栓塞(MCAO)模型,缺血2 h再灌注24 h。采用免疫印迹半定量检测损伤中心脑皮质组织凋亡相关蛋白Bcl-2、Bax和Beclin-1的表达;免疫组织化学检测Bcl-2、Bax和Beclin-1阳性细胞数;TUNEL染色法检测脑组织细胞凋亡。结果:与I/R组相比,Cys C低、中浓度组Bcl-2的表达有不同程度的升高,Bax的表达降低,细胞凋亡减少;而Cys C高浓度组Bcl-2的表达明显降低,Bax的表达显著上升,细胞凋亡增加;Cys C各浓度组Beclin-1的表达都有不同程度的升高。凋亡细胞与Beclin-1表达的相关性分析显示,Cys低、中浓度组细胞的自噬和凋亡呈负相关;Cys C高浓度组细胞的自噬和凋亡呈正相关。结论:Cys C在一定浓度范围内,随自噬蛋白Beclin-1表达的升高可抑制细胞的凋亡,对缺血再灌注损伤脑组织具有保护作用。其作用机制和Bcl-2的表达上调,Bax的表达下调有关;而Cys C较高浓度则无上述作用。     

TNF-α promotes progression of peritoneal metastasis as demonstrated using a green fluorescence protein (GFP)-tagged human gastric cancer cell line

The mechanisms underlying progression of peritoneal metastasis by gastric cancer after micrometastasis formation remain unclear. In the present study, we investigated metastasis to the abdominal wall peritoneum, one of the major features of peritoneal spread, using a human gastric cancer cell line (GCIY-EGFP) tagged with the green fluorescence protein gene (GFP). This model allows sensitive, specific and sequential observation of metastasis development from the initial deposits to peritoneal carcinomatosis at the end stage. In the initial phase, GCIY-EGFP cells could form micrometastasis selectively on the omentum and mesenterium in a milky spot-dependent manner, but not on abdominal wall peritoneum lacking milky spots until the late stages. In vitro analysis using primary mesothelial cells revealed addition of TNF-alpha to decrease their stress fibers, leading to morphological change followed by exposure of the submesothelial extracellular matrix (ECM) in intercellular gaps. Such TNF-alpha pretreatment was found to enhance attachment of tumor cells to the mesothelial monolayer. When tumor cells were injected into the peritoneal cavity of TNF-alpha pretreated mice, they could metastasize to the abdominal wall peritoneum from the very early stages, resulting in accelerated accumulation of ascites than in TNF-alpha non-pretreatment controls. RT-PCR analysis revealed that tumor cells express cytokines and chemokines, including TNF-alpha. Furthermore, TNF-alpha treatment results in up-regulation of expression of monocyte chemoattractant protein-1 (MCP-1) and IL-8 by mesothelial cells and of TNF-alpha itself by inflammatory leukocytes in the peritoneal cavity. These results suggest that metastasis to the abdominal wall peritoneum occurs as a second step from the first omental metastasis in a milky spot-independent manner and that TNF-alpha derived from tumor cells, mesothelial cells and inflammatory leukocytes in the peritoneal cavity may be involved in the progression of peritoneal metastasis.     

Transient receptor potential vanilloid 1 activation induces autophagy in thymocytes through ROS-regulated AMPK and Atg4C pathways

Autophagy is a highly conserved process involved in lymphocyte development and differentiation. Herein, we demonstrated for the first time that triggering of TRPV1 by the specific agonist CPS induces autophagy in mouse thymocytes. TRPV1-dependent autophagy required [Ca(2+)](i) and ROS generation, resulting in AMPK activation. CPS specifically increased Atg4C mRNA expression and induced oxidation of Atg4C protein by ROS generation. TRPV1-triggered autophagy was Atg6/Beclin-1-dependent, as demonstrated by the use of Beclin-1(+/-) transgenic mice, and involved ROS- and AMPK-mediated up-regulation of Beclin-1 expression. Autophagy is activated as a prosurvival process, as its inhibition triggered apoptosis of thymocytes: this effect was accompanied by down-regulation of Atg4C, Bcl-X(L), and Irgm1 mRNA expression, decreased Bcl-X(L) and Beclin-1 protein levels, and caspase-3 activation, suggesting the existence of a molecular interplay between autophagic and apoptotic programs. TRPV1 activation by CPS altered the expression of CD4 and CD8α antigens, inducing the development of DP(dull). Interestingly, we found that CPS induces autophagy of DP(dull) cells, and inhibition of CPS-induced autophagy by the 3-MA autophagic inhibitor induces apoptosis of DP(dull) cells, suggesting the presence of an interplay between autophagic survival and apoptotic cell death. Overall, our findings suggest that DP(dull) cells constitute a distinct thymocyte subpopulation involved in the homeostatic control of cellularity and in the responses to chemical stress signals during thymocyte maturation, via regulating autophagy and apoptosis in a TRPV1-dependent manner.     

Picroside II Protects SH-SY5Y Cells From Autophagy and Apoptosis Following Oxygen Glucose Deprivation/Reoxygen Injury by Inhibiting JNK Signal Pathway

To explore the neuroprotective effect of picroside (Picr) II on C-Jun NH2-terminal kinase (JNK) signal pathway after oxygen glucose deprivation/reoxygen (OGD/R) in SH-SY5Y cells. In vitro, SH-SY5Y cells were used to establish the OGD/R model, which was divided into the control group, model group, Picr group, and SP600125 (SP) group. Cellular viability was measured by CCK8. Cytotoxicity was assessed with LDH assay kit. Ad-GFP-mRFP-LC3 was used to monitor autophagosome and autolysosome. Apoptoic cells were detected by Annexin V-FITC/PI apoptosis detection kit. The expressions of phospho-JNK and phospho-c-Jun were determined by western blot (WB) and immunofluorescence. The expressions of phospho-MKK4, phospho-Bcl-2, Bax, Beclin-1, and LC3 I/II were determined by WB. In the control group, only limited apoptosis and autophagy was observed, and the expression of associated proteins was very low. After OGD/R, the cellular viability of SH-SY5Y cells was reduced, whereas the cytotoxicity, apoptosis, and autophagy were increased, accompanied with an increase of phospho-MKK4, phospho-JNK, phospho-c-Jun, phospho-Bcl-2, LC3 II, Beclin-1, and Bax. During the reoxygen, treatment with Picr II or SP600125 could strengthen the cellular viability of SH-SY5Y cells, but repress the cytotoxicity, apoptosis, autophagy, and the expressions of associated protein. OGD/R could induce apoptosis and autophagy of SH-SY5Y cells by activating JNK signal pathway. Picr II could protect SH-SY5Y cells from autophagy and apoptosis following OGD/R by inhibiting JNK signal pathway. Anat Rec, 302:2245–2254, 2019. © 2019 American Association for Anatomy     

Spatial distribution of cell adhesion molecules on the peritoneal surface in the cecal perforation-induced peritonitis

For understanding the immunological functions of the peritoneum, spatial localization of integrins and their ligands was studied by immuno-SEM on the peritoneal surface of mice with cecal perforation-induced peritonitis. The cecal peritoneum 24 hr after perforation was stained with specific antibodies against LFA-1, Mac-1, VLA-4, ICAM-1, VCAM-1, and fibronectin diluted with cold University of Wisconsin (UW) solution in conjunction with immuno-gold labeling. The spatial localization of those cell adhesion molecules was detected by backscatter electron (BSE) imaging with field emission scanning electron microscope (FESEM). Numerous leukocytes with diverse surface ultrastructure were observed on the peritoneal surface by FESEM. Some leukocytes were in contact with mesothelial cells, and others adhered to the exposed underlying connective tissue. The BSE imaging showed the ubiquitous distribution of Mac-1 on all membrane domains of leukocytes, i.e., cell body, ruffles, and microvilli. In contrast, predominant expressions of LFA-1 and VLA-4 were discernible on ruffles/microvilli of some leukocytes. The mesothelial cells remaining in the inflamed area expressed both ICAM-1 and VCAM-1 on their microvilli. The fibronectin was detected on presumable collagen fibers and/or fibrin over the exposed smooth muscle layer as well as on fibrin extending between leukocyte aggregation. The spatial microlocalization of integrins was clarified on the leukocytes emigrated in peritonitis, and their ligands were detected on the inflamed peritoneum.     

Mesothelial cells from tunica vaginalis, a practical source for mesothelial transplantation

Transplantation of mesothelial cells is used to repair peritoneum that is damaged by surgery, peritonitis, and peritoneal dialysis. The largest obstacle for clinical application of mesothelial cell transplantation is the lack of a reliable source of mesothelial cells. So far, they are isolated from omentum, mesentery, parietal wall and ascites. Procedures used to obtain mesothelial cells from the omentum or mesentery are invasive, however, especially in pre-operative situations. Sufficient amounts of ascites for aspiration can not be obtained under physiological conditions. We have developed a novel method of isolating mesothelial cells from the tunica vaginalis. The tunica vaginalis originates from the peritoneum and descends into the scrotum along with the testis during fetal development. This region provides a source of mesothelial cells that is convenient to approach and free from abdominal complications. Transplantation of autologous mesothelial cells that were isolated from tunica vaginalis was effective in preventing post-operative adhesions. In this review, we summarize mesothelial cell transplantation trials and describe the method of isolating mesothelial cells form the tunica vaginalis. Mesothelial cell transplantation might be widely accepted for clinical use in the near future.     

Spatial distribution of cell adhesion molecules on the peritoneal surface in the cecal perforation‐induced peritonitis

For understanding the immunological functions of the peritoneum, spatial localization of integrins and their ligands was studied by immuno‐SEM on the peritoneal surface of mice with cecal perforation‐induced peritonitis. The cecal peritoneum 24 hr after perforation was stained with specific antibodies against LFA‐1, Mac‐1, VLA‐4, ICAM‐1, VCAM‐1, and fibronectin diluted with cold University of Wisconsin (UW) solution in conjunction with immuno‐gold labeling. The spatial localization of those cell adhesion molecules was detected by backscatter electron (BSE) imaging with field emission scanning electron microscope (FESEM). Numerous leukocytes with diverse surface ultrastructure were observed on the peritoneal surface by FESEM. Some leukocytes were in contact with mesothelial cells, and others adhered to the exposed underlying connective tissue. The BSE imaging showed the ubiquitous distribution of Mac‐1 on all membrane domains of leukocytes, i.e., cell body, ruffles, and microvilli. In contrast, predominant expressions of LFA‐1 and VLA‐4 were discernible on ruffles/microvilli of some leukocytes. The mesothelial cells remaining in the inflamed area expressed both ICAM‐1 and VCAM‐1 on their microvilli. The fibronectin was detected on presumable collagen fibers and/or fibrin over the exposed smooth muscle layer as well as on fibrin extending between leukocyte aggregation. The spatial microlocalization of integrins was clarified on the leukocytes emigrated in peritonitis, and their ligands were detected on the inflamed peritoneum. Anat Rec 264:219–227, 2001. © 2001 Wiley‐Liss, Inc.     

Inflammatory cytokines,angiogenesis, and fibrosis in the rat peritoneum

Peritonitis, a common complication of peritoneal dialysis, is followed by acute changes in the function of the peritoneum. The role of inflammatory cytokines in these processes is not clearly identified. We used adenoviral-mediated gene transfer to transiently overexpress interleukin (IL)-1 beta (AdIL-1 beta) or tumor necrosis factor (TNF)-alpha (AdTNF-alpha) in the rat peritoneum then used a modified equilibrium test to study the histological and functional changes. Overexpression of IL-1 beta or TNF-alpha led to an acute inflammatory response. Both inflammatory cytokines induced an early expression of the angiogenic cytokine, vascular endothelial growth factor, along with increased expression of the profibrotic cytokine, transforming growth factor-beta1, along with fibronectin expression and collagen deposition in peritoneal tissues. Both inflammatory cytokines induced angiogenesis, increased solute permeability, and ultrafiltration dysfunction at earlier time points. Changes in structure and function seen in AdTNF-alpha-treated animals returned to normal by 21 days after infection, whereas AdIL-1 beta-treated animals had persistently increased vasculature with submesothelial thickening and fibrosis. This was associated with up-regulation TIMP-1. TNF-alpha or IL-1 beta both induce acute changes in the peritoneum that mimic those seen in peritoneal dialysis patients who experience an episode of peritonitis. These functional changes were associated with early angiogenesis that resolved rapidly after exposure to TNF-alpha. IL-1 beta exposure, however, led to a different response with sustained vascularization and fibrosis. IL-1 beta inhibition may be a therapeutic goal in acute peritonitis to prevent peritoneal damage.     

Genetic or pharmacologic blockade of enhancer of zeste homolog 2 inhibits the progression of peritoneal fibrosis

Dysregulation of histone methyltransferase enhancer of zeste homolog 2 (EZH2) has been implicated in the pathogenesis of many cancers. However, the role of EZH2 in peritoneal fibrosis remains unknown. We investigated EZH2 expression in peritoneal dialysis (PD) patients and assessed its role in peritoneal fibrosis in cultured human peritoneal mesothelial cells (HPMCs) and murine models of peritoneal fibrosis induced by chlorhexidine gluconate (CG) or high glucose peritoneal dialysis fluid (PDF) by using 3-deazaneplanocin A (3-DZNeP), and EZH2 conditional knockout mice. An abundance of EZH2 was detected in the peritoneum of patients with PD associated peritonitis and the dialysis effluent of long-term PD patients, which was positively correlated with expression of TGF-β1, vascular endothelial growth factor, and IL-6. EZH2 was found highly expressed in the peritoneum of mice following injury by CG or PDF. In both mouse models, treatment with 3-DZNeP attenuated peritoneal fibrosis and inhibited activation of several profibrotic signaling pathways, including TGF-β1/Smad3, Notch1, epidermal growth factor receptor and Src. EZH2 inhibition also inhibited STAT3 and nuclear factor-κB phosphorylation, and reduced lymphocyte and macrophage infiltration and angiogenesis in the injured peritoneum. 3-DZNeP effectively improved high glucose PDF-associated peritoneal dysfunction by decreasing the dialysate-to-plasma ratio of blood urea nitrogen and increasing the ratio of dialysate glucose at 2 h after PDF injection to initial dialysate glucose. Moreover, delayed administration of 3-DZNeP inhibited peritoneal fibrosis progression, reversed established peritoneal fibrosis and reduced expression of tissue inhibitor of metalloproteinase 2, and matrix metalloproteinase-2 and -9. Finally, EZH2-KO mice exhibited less peritoneal fibrosis than EZH2-WT mice. In HPMCs, treatment with EZH2 siRNA or 3-DZNeP suppressed TGF-β1-induced upregulation of α-SMA and Collagen I and preserved E-cadherin. These results indicate that EZH2 is a key epigenetic regulator that promotes peritoneal fibrosis. Targeting EZH2 may have the potential to prevent and treat peritoneal fibrosis. © 2019 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.     

Accumulation of advanced glycation end products and beta 2-microglobulin in fibrotic thickening of the peritoneum in long-term peritoneal dialysis patients

Characteristics of pathological alterations in long-term peritoneal dialysis (PD) are thickening of submesothelial compact (SMC) zone, small-vessel vasculopathy, and loss of mesothelial cells. Bioincompatible PD fluid plays crucial roles in peritoneal injury. Encapsulating peritoneal sclerosis (EPS), a rare and serious complication, occurred in patients on long-term PD or frequent peritonitis episodes, and ~50 % of EPS developed after PD cessation. We hypothesized that PD-related peritoneal injury factors induced by bioincompatible PD fluid accumulated in the peritoneum and might induce EPS. We therefore examined the accumulation of advanced glycation end products (AGE) and beta 2-microglobulin (β2M) in peritoneum and evaluated the relationship between their accumulation, clinical parameters, and outcome after PD cessation. Forty-five parietal peritoneal specimens were obtained from 28 PD patients, 14 uremic patients, and three patients with normal kidney function. The peritoneal equilibration test was used for peritoneal function. AGE- and β2M-expressing areas were found in vascular walls, perivascular areas, and the deep layer of the SMC in short-term PD patients and extended over the entire SMC in long-term patients. Peritonitis and prolonged PD treatment aggravated peritoneal thickening and the proportion of AGE-expressing areas. The proportion of β2M-expressing areas was increased in long-term PD patients. Thickening of the SMC and the proportions of AGE- and β2M-expressing areas were not related to ascites or EPS after PD withdrawal. It appears that the increased proportion of AGE and β2M deposition induced by long-term exposure of PD fluid may be a marker of peritoneal injury.     

c-Jun氨基末端激酶介导的细胞凋亡和自噬参与调控磷酸三钙磨损颗粒诱导的小鼠颅骨假体周围骨细胞死亡

目的 探讨c-Jun氨基末端激酶（JNK）介导的细胞凋亡和自噬是否参与调控磷酸三钙（TCP）磨损颗粒诱导假体周围骨细胞死亡。 方法 取雄性ICR小鼠36只,随机分为3组：正常对照组（control,n=12）、TCP磨损颗粒组（模型组,n=12）和SP6000125组（n=12）。采用TCP磨损颗粒30 mg置于颅骨顶后缝合皮肤构建小鼠颅骨溶解模型,SP6000125组小鼠于术后第2天颅顶注射JNK通路特异性抑制剂SP600125（1.0 mg/kg）,每3日1次。持续干预2周后处死小鼠取颅骨。Calcein-AM探针标记和HE染色观察各组假体周围骨细胞形态和活性变化;通过酶消化法获取假体周围骨细胞,应用流式细胞术检测假体周围骨细胞凋亡情况;Western blotting法检测假体周围骨细胞中Bcl-2、Bax、磷酸化JNK（p-JNK）、Beclin-1和微管相关蛋白1轻链3（LC-3）等蛋白的表达变化。 结果 与control组比较,TCP组假体周围骨细胞活性明显降低,空骨陷窝比例显著增加,骨细胞凋亡明显（P<0.05）,JNK通路被活化,p-JNK蛋白表达明显上调（P<0.05）;自噬相关蛋白Beclin-1和LC-3表达显著上调,且LC-3I向LC-3II转换明显增加（P<0.05）;与TCP组比较,SP600125组假体周围骨细胞凋亡显著减少、自噬被明显抑制（P<0.05）。 结论 JNK介导的细胞凋亡和自噬参与调控TCP磨损颗粒诱导的假体周围骨细胞死亡,促进假体周围骨溶解。     

Fluid dwell impact induces peritoneal fibrosis in the peritoneal cavity reconstructed in vitro

Peritoneal fluid dwell impacts the peritoneum by creating an abnormal physiological microenvironment. Little is known about the precise effects of fluid dwell on the peritoneum, and no adequate in vitro models to analyze the impact of fluid dwell have been established. In this study, we developed a peritoneal fluid dwell model combined with an artificial peritoneal cavity and fluid stirring generation system to clarify the effects of different dwelling solutions on the peritoneum over time. To replicate the peritoneal cavity, we devised a reconstructed peritoneal cavity utilizing a mesothelial layer, endothelial layer, and collagen membrane chamber. The reconstructed peritoneal cavity was infused with Dulbecco’s modified Eagle’s medium, saline, lactated Ringer’s solution or peritoneal dialysis solution with repeated 4-h dwells for 10 or 20 consecutive days. The above-described solutions induced epithelial–mesenchymal transition (EMT) and hyperplasia of mesothelial cells. All solution types modulated nitric oxide synthase activities in mesothelial and endothelial cells and nitric oxide concentrations in dwelling solutions. Inhibition of nitric oxide synthase activity acted synergistically on mesothelial EMT and hyperplasia. The present findings suggest that solutions infused into the peritoneal cavity are likely to affect nitric oxide production in the peritoneum and promote peritoneal fibrosis. Our newly devised peritoneal cavity model should be a promising tool for understanding peritoneal cellular kinetics and homeostasis.     

TREM-1 promoted apoptosis and inhibited autophagy in LPS-treated HK-2 cells through the NF-κB pathway

Triggering receptor expressed by myeloid cells (TREM-1) is an amplifier of inflammatory responses triggered by bacterial or fungal infection. Soluble TREM-1 (sTREM-1) expression was found to be upregulated in sepsis-associated acute kidney injury (SA-AKI) and predicted to be a potential biomarker. However, the mechanism remains unclear. The human kidney-2 (HK-2) cell line was treated with lipopolysaccharide (LPS) and used to examine the potential roles of TREM-1 in apoptosis and autophagy. A cell viability assay was employed to assess the number of viable cells and as a measure of the proliferative index. The concentrations of sTREM-1, interleukin (IL)-1β, tumor necrosis factor-α (TNFα) and IL-6 in cell-free culture supernatants were measured by enzyme-linked immunosorbent assay (ELISA). Western blot analysis was performed to analyze apoptosis, autophagy and the relevant signaling pathways. The results suggested that TREM-1 overexpression after LPS treatment decreased proliferation and increased apoptosis. The concentrations of sTREM-1, IL-1β, TNFα and IL-6 in cell-free culture supernatants were increased in the TREM-1 overexpression group after LPS treatment. Expression of the antiapoptotic gene Bcl-2 was downregulated in the TREM-1 overexpression group, while that of the proapoptotic genes Bax, cleaved caspase-3 and cleaved caspase-9 was upregulated. Overexpression of TREM-1 downregulated expression of the autophagy genes Beclin-1, Atg-5 and LC3b and increased the gene expression of p62, which inhibits autophagy. Conversely, treatment with TREM-1-specific shRNA had the opposite effects. The nuclear factor-κB (NF-κB) signaling pathway (P-p65/p65 and P-IκBα/IκBα) in LPS-induced HK-2 cells was regulated by TREM-1. In summary, TREM-1 promoted apoptosis and inhibited autophagy in HK-2 cells in the context of LPS exposure potentially through the NF-κB pathway.     

腹膜炎大鼠肥大细胞及间皮的形态变化

目的：探讨腹膜炎大鼠间皮细胞的形态变化和肥大细胞的作用。方法：将粪汁注入大鼠腹腔,制成腹膜炎模型。注射后第1、2、3、4h取肠系膜铺片,硫堇染色,光镜观察肥大细胞的数量和形态。间皮细胞的形态做了扫描电镜观察。结果：在腹膜炎的第1～4h,5mm^2肠系膜内可辨认的肥大细胞总数由平均37．7个减至平均13．7个;正在脱颗粒的肥大细胞,由平均1个增至20．8个;核周有少数颗粒的裸核肥大细胞由无增至平均6．1个。间皮细胞的损伤随腹膜炎的发展而加重。结论：肥大细胞释放活性物质,以速发超敏反应参与腹膜炎的病理过程,早期减少腹膜间皮表面积,减少毒素吸收;晚期加速腹膜间皮破坏,增加毒素吸收。     

Hepatocyte growth factor/scatter factor released during peritonitis is active on mesothelial cells

Peritonitis causes mesothelial detachment that may result in persistent peritoneal denudation and fibrosis. We investigated whether hepatocyte growth factor (HGF), a scatter factor that induces detachment from substrate and fibroblastic transformation of several cell types, is produced during peritonitis and is active on mesothelial cells. We studied 18 patients on peritoneal dialysis, 9 uncomplicated, 9 with peritonitis. HGF was measured in serum, peritoneal fluid, and supernatant of peripheral blood mononuclear cells and peritoneal mononuclear cells. Primary culture of human peritoneal mesothelial cells and the human mesothelial cell line MeT-5A were conditioned with recombinant HGF, serum, and peritoneal fluid. HGF levels were significantly higher in serum and peritoneal fluid of peritonitic than uncomplicated patients. Mononuclear cells of peritonitic patients produced more HGF than cells of uncomplicated patients. Recombinant HGF, serum, and peritoneal fluid of peritonitic patients caused mesothelial cell growth, detachment, transformation from epithelial to fibroblast-like shape, overexpression of vimentin, and synthesis of type I and III collagen. In conclusion, HGF released during peritonitis causes a change in mesothelial cell phenotype and function. HGF may affect the healing process facilitating repair through mesothelial cell growth, but may contribute to peritoneal fibrosis inducing cell detachment with mesothelial denudation and collagen synthesis.     

Scanning and transmission electron microscopic study of visceral and parietal peritoneal regions in the rat

The visceral peritoneum of intraabdominal organs (spleen, stomach, liver, small intestine), omentum majus and the parietal peritoneum of the anterior abdominal wall and the diaphragm were studied in adult Wistar rats by combined scanning and transmission electron microscopy (SEM, TEM). In general, the peritoneal surface consisted of a mesothelium composed of cubic, flat or intermediate cell types delimited by a basal lamina. Cubic mesothelial cells predominated in parenchymal organs (spleen, liver) and were characterized by prominent and indentated nuclei, a cytoplasm richly supplied with organelles, a dense microvillous coat, basal invaginations and elaborate intercellular contacts. Flat mesothelial cells were observed in the intestinal, omental and parietal peritoneum (tendinous diaphragm, abdominal wall) and showed elongated nuclei, scant cytoplasm, a poorly developed organelle apparatus and sparsely distributed microvilli. An intermediate mesothelial cell type was described within the gastric peritoneum characterized by a central cytoplasmic protrusion at the nuclear region containing most of the cytoplasmic organelles and by thin finger-like cytoplasmic processes. The submesothelial connective tissue layer was composed of collagen fiber bundles, fibroblasts and free cells (macrophages, granulocytes, mast cells) and contained blood and lymphatic vessels. In the spleen, elastic fibers formed a membranous structure with intercalated smooth muscle cells. Mesothelial openings were observed as tunnel-like invaginations within the hepatic peritoneum and as clusters of peritoneal stomata within the parietal peritoneum of the anterior abdominal wall and the muscular diaphragm. The round or oval openings of the peritoneal stomata were frequently occluded by overlapping adjacent mesothelial cells and their microvillous coat or obstructed by cellular material. At the side of the peritoneal stomata the mesothelial cell layer was interrupted to allow a direct access to the underlying submesothelial lymphatic system. The mesothelium and lymphatic endothelium shared a common basal lamina. The endothelial cells were discontinuous and displayed valve-like plasmalemmatic interdigitations facilitating an intercellular transport of fluids and corpuscular elements from the peritoneal cavity to the submesothelial lymphatic lacunae. The findings underline the morphological heterogeneity of the peritoneum in visceral and parietal regions, suggesting different functional implications, and further support the presence of extra-diaphragmatic peritoneal stomata.     

Nitric oxide production by human peritoneal mesothelial cells

Nitric oxide (NO) has multiple actions, ranging from immunomodulation to regulation of vascular tone and capillary flow. Thus NO generation within the peritoneum could potentially affect peritoneal transport by increasing capillary vasodilatation, and regulate the response to bacterial invasion. Peritoneal mesothelial cells have a common embryological derivation with endothelial cells. As mesothelial cells are the predominant cell type lining the peritoneal cavity, they could potentially be a major source of locally produced nitric oxide. Nitric oxide was measured using the Griess reaction, as total nitrite and nitrate, in fresh unused and spent dialysate effluent (SPDE) from both healthy peritoneal dialysis patients, and during episodes of bacterial peritonitis. Whereas fresh CAPD dialysate was nitrite free (5 +/- 0.1 microM), SPDE from a standard 4 h day time exchange contained 10.2 +/- 0.6 microM/L/h, and that from the overnight dwell 9.1 +/- 0.7 microM/L/h. During an episode of peritonitis, dialysate nitrite and nitrate increased significantly from 9.0 +/- 1.0 microM/L/h, when not infected to 17.5 +/- 2.4, from the first CAPD bag drained at presentation, and 15.2 +/- 1.8 for the second and 16.0 +/- 2.5 for the third exchange (p<0.01). By the following day nitrite levels had returned to baseline, 7.0 +/- 1.0 microM/L/h. Human peritoneal mesothelial cells (HPMC) were cultured and found to produce nitric oxide (261 nmol/mg cell protein), which increased in a dose dependent manner with the addition of spent uninfected CAPD dialysate. The addition of L-arginine, a NO substrate resulted in a 10% increase in nitric oxide production, whereas the addition of the blocker L-NMMA produced a 10% reduction. RNA for inducible nitric oxide synthase (iNOS) was sought using northern blotting technique following combination stimulation with lipopolysaccharide and cytokines (IL-1beta, TNFalpha and gamma-INF, and/or spent dialysate from patients with bacterial peritonitis). However, we could not demonstrate RNA production for iNOS. Peritoneal mesothelial cells may be an important source of locally generated nitric oxide within the peritoneal cavity under basal conditions, but as they do not contain iNOS, the markedly increased NO production observed with episodes of acute bacterial peritonitis is more likely due to a combination of increased NO production by peritoneal macrophages and endothelial cells.     

大鼠膈腹膜间皮通透性的电镜观察

腹膜腔内注射兔血液和中墨汁后，用电镜观察了大鼠膈腹膜间皮对示踪剂血细胞和碳颗粒的通透笥。在膈膜隐窝区，示踪剂经三种途径通过膈腹膜间皮。（１）间皮孔的吸收作用。示踪剂由腹膜腔经间皮孔直接进入膈毛细淋巴管，或被成纤维细胞的突起包绕。（２）间皮细胞的吞噬作用。（３）示踪剂通过间皮细胞间裂隙或细胞间连接。