Low-GDP, pH-neutral solutions preserve peritoneal endothelial glycocalyx during long-term peritoneal dialysis
Low-GDP, pH-neutral solutions preserve peritoneal endothelial glycocalyx during long-term peritoneal dialysis
复制标题
低 GDP、pH 中性溶液可在长期腹膜透析过程中保护腹膜内皮糖萼
DOI：
10.1007/s10157-021-02078-9
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发表时间：
2021
期刊：
影响因子：
2.3
通讯作者：
Ito Y.
中科院分区：
文献类型：
--
作者：
Sugiyama N;Tawada M;Sun T;Suzuki Y;Kinashi H;Yamaguchi M;Katsuno T;Aten J;Vlahu CA;van Kuppevelt TH;Takei Y;Ishimoto T;Maruyama S;Mizuno M;Ito Y.
研究背景腹膜透析（PD）过程中，溶质转运和超滤主要通过腹膜血管系统实现。糖萼位于内皮细胞表面，在血管通透性中发挥作用。据报道，低葡萄糖降解产物 (GDP)、pH 中性腹膜透析溶液可提供更高的生物相容性，并减少腹膜损伤。然而，对脉管系统的影响尚未阐明。方法对11例接受常规酸性溶液治疗的患者（酸性组）和11例接受低GDP、pH中性溶液治疗的患者（中性组）的腹膜组织进行了检查。对照组织取自 5 名健康肾移植捐献者（对照组）。评估 CD31 和管腔直径与血管直径的比率（L/V 比率）以分别识别内皮细胞和血管病变。通过硫酸乙酰肝素（HS）结构域和紫荆花凝集素-1（UEA-1）结合的免疫染色来评估硫酸化糖胺聚糖和糖萼的含岩藻糖糖链。结果与酸性组相比，中性组表现出更高的CD31阳性率。中性组的 L/V 比值显着较高，表明血管病变进展较少。中性组中 HS 表达和 UEA-1 结合均较高，而酸性组中 HS 表达明显高于 UEA-1 结合。在仅在酸性组中发现的低 L/V 比的血管中，HS 表达和 UEA-1 结合减少，表明糖萼丢失。 结论 在用低 GDP、pH 中性溶液治疗的患者中，腹膜内皮糖萼保存得更好。使用低 GDP、pH 中性溶液有助于保护腹膜血管结构和功能。
BackgroundDuring peritoneal dialysis (PD), solute transport and ultrafiltration are mainly achieved by the peritoneal blood vasculature. Glycocalyx lies on the surface of endothelial cells and plays a role in vascular permeability. Low-glucose degradation product (GDP), pH-neutral PD solutions reportedly offer higher biocompatibility and lead to less peritoneal injury. However, the effects on the vasculature have not been clarified.MethodsPeritoneal tissues from 11 patients treated with conventional acidic solutions (acidic group) and 11 patients treated with low-GDP, pH-neutral solutions (neutral group) were examined. Control tissues were acquired from 5 healthy donors of kidney transplants (control group). CD31 and ratio of luminal diameter to vessel diameter (L/V ratio) were evaluated to identify endothelial cells and vasculopathy, respectively. Immunostaining for heparan sulfate (HS) domains andUlex europaeusagglutinin-1 (UEA-1) binding was performed to assess sulfated glycosaminoglycans and the fucose-containing sugar chain of glycocalyx.ResultsCompared with the acidic group, the neutral group showed higher CD31 positivity. L/V ratio was significantly higher in the neutral group, suggesting less progression of vasculopathy. Both HS expression and UEA-1 binding were higher in the neutral group, whereas HS expression was markedly more preserved than UEA-1 binding in the acidic group. In vessels with lowL/Vratio, which were found only in the acidic group, HS expression and UEA-1 binding were diminished, suggesting a loss of glycocalyx.ConclusionPeritoneal endothelial glycocalyx was more preserved in patients treated with low-GDP, pH-neutral solution. The use of low-GDP, pH-neutral solutions could help to protect peritoneal vascular structures and functions.