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Cells and Matrix |
Department of Medicine, University of Hong Kong, Hong Kong SAR, PR China
Correspondence to: S. Yung, Department of Medicine, Room 302, New Clinical Building, Queen Mary Hospital, Pokfulam, Hong Kong SAR, PR China. ssyyung{at}hkucc.hku.hk
Background: By virtue of their high net negative
charge, glycosaminoglycans and proteoglycans play pivotal roles in biologic
processes such as cell–cell and cell–matrix interactions,
sequestration of growth factors, activation of chemokines and cytokines, and
permselectivity of basement membranes. Methods: The present article reviews the putative roles
of glycosaminoglycans and proteoglycans in the peritoneal cavity during normal
peritoneal homeostasis and chronic inflammation, the latter induced by
constant exposure of the peritoneum to non-physiologic peritoneal dialysis
(PD) solutions. Results: Glycosaminoglycans have been identified in the
mesothelial glycocalyx, a slippery, non-adhesive layer that protects the
peritoneal membrane from abrasion and infection. Dermatan sulfate
proteoglycans can neutralize the activity of transforming growth factor
β1 and can thus play an essential role in modulating peritoneal fibrosis.
Heparan sulfate proteoglycans play a crucial role in the sequestration of
growth factors; they also modulate selective permeability of proteins across
the peritoneal cavity. Reduced expression of perlecan, a heparan sulfate
proteoglycan of the basement membrane, is observed in peritoneal biopsies
obtained from established PD patients, consequent to prolonged exposure to the
elevated glucose concentrations in conventional PD solutions. Supplementation
of PD fluids with glycosaminoglycans has been shown to be beneficial to both
the structural and functional integrity of the peritoneum. Conclusions: Recent advances in the field of
glycobiology have revealed a multitude of biologic processes that are
controlled or influenced by glycosaminoglycans and proteoglycans. Altered
synthesis of these macromolecules during PD has serious implications for the
peritoneal transport of proteins, host defense, wound healing, inflammation,
and fibrosis.
KEY WORDS: Decorin; perlecan; hyaluronan; mesothelial cells.
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