Bajo M A, del Peso G, Castro M A, Díaz C, Castro M J, Gil F, Sánchez-Tomero J A, Selgas R
Hospitales Universitarios La Paz, Madrid, Spain.
Adv Perit Dial. 2001;17:37-41.
Peritoneal membrane suffers structural and functional changes over time on peritoneal dialysis (PD)--in part, owing to the dialysis solutions currently used. Low pH seems to be an important element associated with solution bioincompatibility. Bicarbonate-containing fluids open new perspectives on this issue. The present study compared the effects of bicarbonate/lactate (Bic/Lac) solution (25 mmol/L bicarbonate, 15 mmol/L lactate) and lactate (Lac) solution (40 mmol/L lactate) on mesothelial cell (MC) growth in culture. Eight stable PD patients were asked to collect peritoneal effluent from an 8-hour dwell on two separate days, within an interval shorter than one week. For the first dwell, Lac solution was infused; for the second dwell, Bic/Lac solution was instilled. Human MCs were isolated from the effluent, seeded in 25-cm2 tissue culture flasks, and grown ex vivo. Morphology of the cells was also evaluated. In all effluents, MCs were present in mean amounts of 26,939 +/- 21,267 cells (Bic/Lac) and 25,986 +/- 15,286 cells [Lac, p = nonsignificant (NS)]. Morphology of the MCs was similar with both solutions (87.5% typical). After initial culture, MCs from 6 patients using Bic/Lac (75%) and 3 patients using Lac (37.5%) reached confluence. At this time, the number of MCs from the 3 patients who showed MC growth with both solutions was slightly higher with Bic/Lac-buffered fluid (Lac: 1,154,125 +/- 213,333 cells; Bic/Lac: 1,198,291 +/- 806,713 cells). To summarize: 3 patients showed MC growth under both solutions; 3 patients showed MC growth only under Bic/Lac solution; and 2 patients showed no MC growth at all. After cells were seeded in 24-well plates, the MC growth curve was performed in 4 cases of Bic/Lac solution use and in 3 cases of Lac solution use. Although no significant differences were observed between the solutions, the final number of MCs obtained was higher with Bic/Lac solution use. In conclusion, MCs released into peritoneal effluent under bicarbonate/lactate-buffered peritoneal dialysis solution are associated with a greater ex vivo proliferation capacity than those released under lactate solution in the same patient. This finding may demonstrate better biocompatibility for Bic/Lac solution.
随着时间的推移，腹膜在腹膜透析（PD）过程中会发生结构和功能的变化，部分原因是目前使用的透析液。低pH似乎是与溶液生物不相容性相关的一个重要因素。含碳酸氢盐的液体为这个问题开辟了新的前景。本研究比较了碳酸氢盐/乳酸盐（Bic/Lac）溶液（25 mmol/L碳酸氢盐，15 mmol/L乳酸盐）和乳酸盐（Lac）溶液（40 mmol/L乳酸盐）对培养的间皮细胞（MC）生长的影响。8名稳定的PD患者被要求在间隔短于一周的两天内，从8小时的驻留中收集腹膜流出液。第一次驻留时，注入Lac溶液；第二次驻留时，注入Bic/Lac溶液。从流出液中分离出人MC，接种到25 cm²组织培养瓶中，进行体外培养。还对细胞的形态进行了评估。在所有流出液中，MC的平均数量为26,939±21,267个细胞（Bic/Lac）和25,986±15,286个细胞[Lac，p =无显著性差异（NS）]。两种溶液培养的MC形态相似（87.5%为典型形态）。初始培养后，使用Bic/Lac的6名患者（75%）和使用Lac的3名患者（37.5%）的MC达到汇合。此时，在两种溶液中均显示MC生长的3名患者的MC数量，在Bic/Lac缓冲液中略高（Lac：1,154,125±213,333个细胞；Bic/Lac：1,198,291±806,713个细胞）。总结如下：3名患者在两种溶液下均显示MC生长；3名患者仅在Bic/Lac溶液下显示MC生长；2名患者根本没有MC生长。将细胞接种到24孔板后，对4例使用Bic/Lac溶液和3例使用Lac溶液的情况进行了MC生长曲线测定。虽然两种溶液之间未观察到显著差异，但使用Bic/Lac溶液获得的MC最终数量更高。总之，在碳酸氢盐/乳酸盐缓冲的腹膜透析液下释放到腹膜流出液中的MC，与同一患者在乳酸盐溶液下释放的MC相比，具有更大的体外增殖能力。这一发现可能表明Bic/Lac溶液具有更好的生物相容性。
