Second Department of Internal Medicine, Nagasaki University School of Medicine, Nagasaki, Japan.
Ren Fail. 2012;34(6):760-6. doi: 10.3109/0886022X.2012.676527. Epub 2012 Apr 17.
Peritoneal fibrosis is a serious complication in patients with severe chronic kidney disease who are undergoing peritoneal dialysis (PD). One of the pathological characteristics of peritoneal fibrosis is the infiltration of macrophages in the thickened submesothelial compact zone. In addition, infiltration of lymphocytes, including T and B lymphocytes, is observed in the fibrotic peritoneum. However, the relationship between lymphocyte infiltration and progression of peritoneal fibrosis remains unclear. In this study, we investigated the role of lymphocytes in the development of peritoneal fibrosis induced by chlorhexidine gluconate (CG) by comparing the histological changes observed in severe combined immunodeficient (SCID) mice (largely lacking functional T and B lymphocytes) with those observed in wild-type (WT) mice. As expected, CG-injected WT mice showed a thickening of the submesothelial compact zone together with massive collagen deposition accompanied by increased numbers of infiltrating macrophages and T and B lymphocytes. In the peritoneum of SCID mice, the submesothelial compact zone was thicker and the number of macrophages and B lymphocytes was significantly higher than that observed in control immunodeficient and WT mice. In contrast, the number of T lymphocytes in the peritoneum of SCID mice was significantly lower than that in the peritoneum of WT mice. These results suggest that T and B lymphocytes modulate the process of peritoneal fibrosis via macrophage infiltration.
腹膜纤维化是接受腹膜透析(PD)的严重慢性肾脏病患者的严重并发症。腹膜纤维化的病理特征之一是巨噬细胞浸润到增厚的亚上皮致密区。此外,在纤维化的腹膜中还观察到淋巴细胞(包括 T 淋巴细胞和 B 淋巴细胞)的浸润。然而,淋巴细胞浸润与腹膜纤维化的进展之间的关系尚不清楚。在这项研究中,我们通过比较严重联合免疫缺陷(SCID)小鼠(缺乏功能性 T 和 B 淋巴细胞)和野生型(WT)小鼠观察到的组织学变化,研究了葡萄糖酸氯己定(CG)诱导的腹膜纤维化中淋巴细胞的作用。正如预期的那样,CG 注射的 WT 小鼠表现出亚上皮致密区的增厚,伴随着大量胶原沉积,同时伴有浸润巨噬细胞和 T、B 淋巴细胞数量的增加。在 SCID 小鼠的腹膜中,亚上皮致密区较厚,巨噬细胞和 B 淋巴细胞的数量明显高于对照免疫缺陷和 WT 小鼠。相比之下,SCID 小鼠腹膜中的 T 淋巴细胞数量明显低于 WT 小鼠。这些结果表明,T 和 B 淋巴细胞通过巨噬细胞浸润调节腹膜纤维化的过程。