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Perit Dial Int 18(2): 157-165 1998
© 1998 International Society for Peritoneal Dialysis
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Peritoneal Dialysis International, Vol 18, Issue 2, 157-165
Copyright © 1998 by International Society for Peritoneal Dialysis

Articles

Surfactant barrier lining peritoneal mesothelium: lubricant and release agent

BA Hills, Burke JR, and K Thomas

Paediatric Respiratory Research Centre, Mater Children's Hospital, South Brisbane, Queensland, Australia.

OBJECTIVE: Five studies are described to determine whether there is an outermost lining of surface-active phospholipid (SAPL) adsorbed to the peritoneum and to quantify its ability to act as a release (antistick) agent and boundary lubricant by standard tests. METHODS: Using a hydrophobic probe (phosphin E), epifluorescence microscopy was used to demonstrate an outermost lining of oligolamellar SAPL by spectral analysis of the emitted light, a finding consistent with the appreciable hydrophobicity demonstrated on canine peritoneal mesothelium and its virtual elimination by incubation with bile salt. Good release and excellent lubricating capabilities of human peritoneal SAPL have been quantified as the release factor and coefficient of friction, respectively, by standard tests from the physical sciences. RESULTS: A well-defined outermost layer was clearly visible on peritoneal mesothelium whose color spectrum was identical to that produced by pure phosphatidylcholine ultrasonicated into its oligolamellar state. Further evidence for a SAPL lining was demonstrated by a parietal contact angle of 43 degrees (47 degrees visceral) on this surface and its virtual elimination by incubation with dilute bile salt. Human SAPL from continuous ambulatory peritoneal dialysis (CAPD) effluent proved an effective release agent, reducing adhesion by 67%, and an excellent lubricant as quantified by a coefficient of friction of 0.091 under load (1.9 kg/cm2). CONCLUSIONS: The good release and excellent lubricating properties of SAPL adsorbed to mesothelial surfaces are highly desirable in reducing wear and exfoliation of epithelial cells. In spanning epithelial cells, the same lining might also serve to render tight junctions tight and reduce macromolecular escape while compatible with many aspects of CAPD, including lipid permeability and conflicting results obtained from administering exogenous SAPL.




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