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Clinical |
1 Department of Nephrology, Transplantology and Internal Medicine, 2 and Department of Pathophysiology, Medical University of Gdansk;3 Chair of Cell and Molecular Biology, University of Gdansk, Poland
Correspondence to: T. Liberek, Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdansk, Ul. Debinki 7, 80-211 Gdansk, Poland. tlib{at}amg.gda.pl
Background: One of the main limitations of peritoneal
dialysis (PD) is deterioration of functional and morphological characteristics
of the peritoneum. This complication appears to be related to the low
biocompatibility profile of PD fluids. Recently, induction of the heat shock
protein (HSP) stress response was demonstrated in cultured human mesothelial
cells exposed to PD fluid in vitro. We investigated whether
expression of heat shock protein 72 (HSP-72) in peritoneal macrophages is
induced upon exposure to PD fluid during continuous ambulatory PD.
Methods: Peritoneal leukocytes were isolated from 4-hour
dwell dialysate; peripheral blood mononuclear cells (PBMC) and peripheral
blood monocytes isolated from the same patients were used as a control. In
separate experiments, PBMC from healthy individuals were exposed in
vitro to different PD fluids or to culture media. Expression of HSP-72
was assessed by Western immunoblotting, flow cytometry, and
reverse-transcription polymerase chain reaction analysis.
Results: Macrophages and leukocytes isolated from dialysis
effluent expressed significantly increased HSP-72 and mRNA levels compared to
blood monocytes and PBMC of the same patients. In vitro exposure of
PBMC to fresh PD fluids resulted in significantly higher expression of HSP-72
compared to those incubated in culture medium. PBMC exposed in vitro
to standard lactate-buffered dialysis fluids also expressed significantly more
HSP-72 compared to cells exposed to bicarbonate/lactate-buffered fluids.
Conclusion: Our results indicate that exposure to PD
fluids during dialysis triggers a shock response in peritoneal cells, which is
manifested by significantly increased HSP-72 expression at both protein and
mRNA levels. Analysis of this protein expression in peritoneal macrophages
could be a new, convenient, and relevant way to assess the biocompatibility of
PD fluids ex vivo.
KEY WORDS: KEY WORDS:; Heat shock proteins; biocompatibility; peritoneal dialysis fluids.
Received 13 September 2006; accepted 29 December 2006.
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