腹膜透析滤出液生物标志物的研究进展

长期腹膜透析可导致腹膜形态和功能的改变。腹膜功能评估主要通过小分子溶质和液体清除两方面来评估,相对简单。但形态学上的评估则要依靠腹膜活检,在临床应用中很难施行。如何能准确、方便、无创地评价腹膜的变化,一直备受关注。腹膜组织长期浸泡在腹膜透析液中,必然会分泌或脱落一些物质,是腹膜透析患者独特且方便的检测标本,因此通过回收腹膜透析滤出液,寻找并测定这些物质,将有助于了解腹膜的病理生理变化。因此,本文针对腹膜透析研究中新兴的候选生物标志物进行了汇总,并就其临床应用前景做一综述。     

高浓度葡萄糖对人腹膜间皮细胞的损伤作用及对其增殖的影响

高浓度葡萄糖对人腹膜间皮细胞的损伤作用及对其增殖的影响臧燕，侯凡凡，杨铁成，杨满球ＨＩＧＨＧＬＵＣＯＳＥＩＮＤＵＣＥＳＣＥＬＬＤＡＭＡＧＥＡＮＤＩＮＨＩＢＩＴＳＣＥＬＬＰＲＯＬＩＦＥＲＡＴｌＯＮＩＮＨＵ－ＭＡＮＰＥＲＩＴＯＮＥＡＬＭＥＳＯＴＨＥＬＩＡ...     

腹膜衰竭中羰基应激的研究进展

腹膜衰竭当前已成为影响腹膜透析的主要问题，腹膜衰竭时所发生的变化就是在血液和透析液间小分子溶质交换的功能区逐渐增大，而这些变化与活性羰基化合物的超负荷所引起的新生血管的形成和原有血管结构的改变有关。     

腹膜透析与腹膜的血管生成

在长期腹膜透析中，腹膜的血管生成是腹膜结构变化的重要表现，腹膜的血管生成影响着腹膜的功能变化，本文就腹膜血管生成的特征、原因、调控因子以及治疗前景作一综述。     

腹膜透析与腹膜的血管生成

在长期腹膜透析中 ,腹膜的血管生成是腹膜结构变化的重要表现 ,腹膜的血管生成影响着腹膜的功能变化 ,本文就腹膜血管生成的特征、原因、调控因子以及治疗前景作一综述。     

腹膜衰竭中羰基应激的研究进展

腹膜衰竭当前已成为影响腹膜透析的主要问题。腹膜衰竭时所发生的变化就是在血液和透析液间小分子溶质交换的功能区逐渐增大 ,而这些变化与活性羰基化合物的超负荷所引起的新生血管的形成和原有血管结构的改变有关     

川芎嗪抗腹膜间皮细胞损伤的实验研究

目的：观察含川芎嗪腹透液体外对腹膜间皮细胞活力,细胞增殖的影响。方法：分离,培养大鼠腹膜间皮细胞,用细胞计数法,四唑氨蓝（MTT）法,乳酸脱氢酶（LDH）法检测腹膜间皮细胞活力,细胞增殖能力。结果：培养的腹膜间皮细胞暴露于常规使用的4．25％高糖透析液30min后,间皮细胞数量显降低,MTT法示OD值显低于正常对照组,LDH释放增加,提示间皮细胞活力降低,增殖受到显抑制,加入低剂量川芎嗪后,间皮细胞数,MTTOD值较之单纯高糖透析液组均显增高,LDH显降低,但随着剂量的加大,川芎嗪的上述作用减低乃至消失,结论：适当剂量的川芎嗪能对抗常规腹透液引起的间皮细胞抑制和损伤,从而具有保护间皮细胞的作用。     

腹膜透析残余肾功能的研究进展

本文简要阐述了腹膜透析患者残余肾功能降低的机制,腹膜透析对保护残余肾功能的优势,以及影响腹膜透析患者残余肾功能的相关因素与保护残余肾功能的方法.     

腹膜透析残余肾功能的研究进展

本文简要阐述了腹膜透析患者残余肾功能降低的机制,腹膜透析对保护残余肾功能的优势,以及影响腹膜透析患者残余肾功能的相关因素与保护残余肾功能的方法。     

腹膜透析动物模型研究进展

随着腹膜透析基础研究的进一步发展，腹膜透析模型被广泛采用，使得研究人员对于感染性腹膜炎导致腹膜形态和转运的影响、腹膜透析中腹膜微循环改变、腹膜与血液之闻溶质转运、超滤动力学、淋巴重吸收等腹膜病理生理改变，认识进一步提高。此外，腹膜透析模型还被广泛应用于新型腹膜透析渗透剂及其生物相容性、腹膜透析药物动力学等方面研究，已取得重要进展。     

Octreotide lessens peritoneal injury in experimental encapsulated peritoneal sclerosis model

Aim: Encapsulated peritoneal sclerosis is characterized by neoangiogenesis and fibrosis. Octreotide, a somatostatin analogue is a well‐known antifibrotic, antiproliferative and anti‐angiogenic agent. The aim of the study is to evaluate the effects of octreotide in encapsulated peritoneal sclerosis‐induced neoangiogenesis and fibrosis and compare the results with resting. Methods: Non‐uraemic Wistar‐Albino male rats (n = 35) were divided into four groups. Group I, control rats, received 2 mL isotonic saline i.p. daily for 3 weeks. Group II, received daily i.p. 2 mL/200 g injection of chlorhexidine gluconate (0.1%) and ethanol (%15) dissolved in saline for 3 weeks. Group III, chlorhexidine gluconate for 3 weeks plus an additional 3 weeks without any treatment (rest), to a total of 6 weeks. Group IV, chlorhexidine gluconate for 3 weeks plus an additional 3 weeks octreotide, 50 mcg/kg bodyweight s.c., for a total of 6 weeks. Results: Octreotide significantly reversed ultrafiltration capacity of peritoneum with decreasing inflammation, neoangiogenesis and fibrosis compared to the resting group. Octreotide also caused inhibition of dialysate transforming growth factor‐β1, vascular endothelial growth factor and monocyte chemotactic protein‐1 activity and improved mesothelial cell cytokeratin expression. Peritoneal resting has no beneficial effects on peritoneum. Conclusion: In conclusion, octreotide may have a therapeutic value in peritoneal dialysis patients who suffer from encapsulated peritoneal sclerosis.     

CD147 expression in peritoneal injury

Background

Peritoneal injury is an important cause of technical failure of long-term peritoneal dialysis (PD). Encapsulating peritoneal sclerosis (EPS) is a severe complication of long-term PD with potentially life threatening consequences. CD147 is a glycoprotein with diverse functions including modulation of extracellular matrix via induction of matrix metalloproteinases, cell adhesion, and regulation of immune reactions. We hypothesized that CD 147 plays a role in the peritoneal cavity.

Methods

In this retrospective study, we localized CD147 by immunohistochemistry in peritoneal biopsies from uremic patients not on PD (n?=?8), on PD without signs of EPS (n?=?7), and in biopsies in patients with the diagnosis of EPS (n?=?7). Double immunofluorescence was used to co-localize α-smooth-muscle actin (α-SMA) and CD147 in selected biopsies from each group. Expression was scored semi-quantitatively.

Results

In biopsies from uremic controls, CD147 was prominently expressed in mesothelial cells, focally between fat cells and by some perivascular cells. In patients on PD, a similar distribution was present (although mesothelium was rarely conserved), with some focal accentuation. In EPS, layers of fibroblastic cells were positive for CD147. EPS biopsies demonstrated a significantly higher score in a blinded evaluation, compared to uremic patients. Cells expressing CD147 were α-SMA positive myofibroblasts as demonstrated by double immunofluorescence. Mean CD147 scores did not differ between patients with different transporter status.

Conclusions

This is the first study demonstrating CD147 on a major part of fibroblastic cells in EPS. Future studies need to address the role of these cells in this severe complication of long-term PD.

     

Establishment of a novel mouse peritoneal dialysis-associated peritoneal injury model

Clinical and Experimental Nephrology - Peritoneal fibrosis induced by various factors during peritoneal dialysis (PD) can eventually lead to ultrafiltration failure and termination of PD treatment....     

Role of biomarkers in acute traumatic lung injury

In severely injured patients severe thoracic trauma is common and can significantly influence the outcome of these critically ill patients by increased rates of mainly pulmonary complications. Furthermore, patients who sustained thoracic trauma are at increased risk for Acute Lung Injury (ALI) or Adult Respiratory Distress Syndrome (ARDS). Therapeutic options are limited, basically consisting of prophylactic antibiotic therapy and changing patient’s positions. It is known, that ALI and ARDS differ clinically and pathobiologically from ALI/ARDS caused by other reasons, but the exact pathology remains elusive. Due to that no reliable predictive or surveillance biomarkers could be established for clinical diagnosis and identification of patients at high risk for acute traumatic lung injury. Nevertheless, there are plenty of promising markers that need to be further elucidated in larger case numbers and multicenter studies. This article sums up the recent status of those promising clinical biomarkers.     

Serum biomarkers of neurologic injury in cardiac operations

Assessment of subtle neurocognitive decline after surgical procedures has been hampered by heterogeneous testing techniques and a lack of reproducibility. This review summarizes the sensitivity and specificity of biomarkers of neurologic injury to determine whether they can be applied in the postoperative period to accurately predict neurocognitive decline. Creatine kinase-brain type, neuron-specific enolase, and S100B can be released into serum during operations by extracranial sources. Glial fibrillary acidic protein is a sensitive marker, and there are extracranial sources that are antigenically different from the brain-derived form. Serum levels of tau protein after acute neurologic injury do not reliability correlate with incidence.     

Some biomarkers of acute kidney injury are increased in pre-renal acute injury

Pre-renal acute kidney injury (AKI) is assumed to represent a physiological response to underperfusion. Its diagnosis is retrospective after a transient rise in plasma creatinine, usually associated with evidence of altered tubular transport, particularly that of sodium. In order to test whether pre-renal AKI is reversible because injury is less severe than that of sustained AKI, we measured urinary biomarkers of injury (cystatin C, neutrophil gelatinase-associated lipocalin (NGAL), γ-glutamyl transpeptidase, IL-18, and kidney injury molecule-1 (KIM-1)) at 0, 12, and 24?h following ICU admission. A total of 529 patients were stratified into groups having no AKI, AKI with recovery by 24?h, recovery by 48?h, or the composite of AKI greater than 48?h or dialysis. Pre-renal AKI was identified in 61 patients as acute injury with recovery within 48?h and a fractional sodium excretion <1%. Biomarker concentrations significantly and progressively increased with the duration of AKI. After restricting the AKI recovery within the 48?h cohort to pre-renal AKI, this increase remained significant. The median concentration of KIM-1, cystatin C, and IL-18 were significantly greater in pre-renal AKI compared with no-AKI, while NGAL and γ-glutamyl transpeptidase concentrations were not significant. The median concentration of at least one biomarker was increased in all but three patients with pre-renal AKI. Thus, the reason why some but not all biomarkers were increased requires further study. The results suggest that pre-renal AKI represents a milder form of injury.