Margetts Peter J, Kolb Martin, Yu Lisa, Hoff Catherine M, Holmes Clifford J, Anthony Daniel C, Gauldie Jack
Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada.
Am J Pathol. 2002 Jun;160(6):2285-94. doi: 10.1016/S0002-9440(10)61176-5.
Peritonitis, a common complication of peritoneal dialysis, is followed by acute changes in the function of the peritoneum. The role of inflammatory cytokines in these processes is not clearly identified. We used adenoviral-mediated gene transfer to transiently overexpress interleukin (IL)-1 beta (AdIL-1 beta) or tumor necrosis factor (TNF)-alpha (AdTNF-alpha) in the rat peritoneum then used a modified equilibrium test to study the histological and functional changes. Overexpression of IL-1 beta or TNF-alpha led to an acute inflammatory response. Both inflammatory cytokines induced an early expression of the angiogenic cytokine, vascular endothelial growth factor, along with increased expression of the profibrotic cytokine, transforming growth factor-beta1, along with fibronectin expression and collagen deposition in peritoneal tissues. Both inflammatory cytokines induced angiogenesis, increased solute permeability, and ultrafiltration dysfunction at earlier time points. Changes in structure and function seen in AdTNF-alpha-treated animals returned to normal by 21 days after infection, whereas AdIL-1 beta-treated animals had persistently increased vasculature with submesothelial thickening and fibrosis. This was associated with up-regulation TIMP-1. TNF-alpha or IL-1 beta both induce acute changes in the peritoneum that mimic those seen in peritoneal dialysis patients who experience an episode of peritonitis. These functional changes were associated with early angiogenesis that resolved rapidly after exposure to TNF-alpha. IL-1 beta exposure, however, led to a different response with sustained vascularization and fibrosis. IL-1 beta inhibition may be a therapeutic goal in acute peritonitis to prevent peritoneal damage.
腹膜炎是腹膜透析的常见并发症,随之而来的是腹膜功能的急性改变。炎症细胞因子在这些过程中的作用尚未明确。我们利用腺病毒介导的基因转移技术,使大鼠腹膜中白细胞介素(IL)-1β(AdIL-1β)或肿瘤坏死因子(TNF)-α(AdTNF-α)瞬时过表达,然后采用改良的平衡试验来研究组织学和功能变化。IL-1β或TNF-α的过表达导致急性炎症反应。两种炎症细胞因子均诱导血管生成细胞因子血管内皮生长因子的早期表达,同时促纤维化细胞因子转化生长因子-β1的表达增加,以及腹膜组织中纤连蛋白表达和胶原沉积增加。两种炎症细胞因子均在早期时间点诱导血管生成、溶质通透性增加和超滤功能障碍。AdTNF-α处理的动物在感染后21天,其结构和功能变化恢复正常,而AdIL-1β处理的动物则持续存在血管增多、间皮下增厚和纤维化。这与金属蛋白酶组织抑制因子-1(TIMP-1)上调有关。TNF-α或IL-1β均诱导腹膜急性变化,类似于经历腹膜炎发作的腹膜透析患者所出现的变化。这些功能变化与早期血管生成有关,暴露于TNF-α后血管生成迅速消退。然而,暴露于IL-1β会导致不同的反应,即血管持续化和纤维化。抑制IL-1β可能是急性腹膜炎预防腹膜损伤的治疗目标。