Kihm Lars P, Müller-Krebs Sandra, Holoch Sandra, Schmuck Svenja, Becker Luis E, Brownlee Michael, Zeier Martin, Fleming Thomas H, Nawroth Peter P, Schwenger Vedat
Department of Nephrology, University of Heidelberg, Heidelberg, Germany Department of Internal Medicine I and Clinical Chemistry, University of Heidelberg, Heidelberg, Germany.
Department of Nephrology, University of Heidelberg, Heidelberg, Germany.
Nephrol Dial Transplant. 2015 Mar;30(3):401-9. doi: 10.1093/ndt/gfu346. Epub 2014 Nov 11.
Peritoneal dialysis (PD) is limited by peritoneal fibrosis and ultrafiltration failure. This is in part caused by the high concentration of glucose degradation products (GDPs) present in PD fluids (PDF) as a consequence of heat sterilization. Existing research in long-term PD has mainly dealt with the toxicity induced by GDPs and the development of therapeutic strategies to reduce the cellular burden of GDPs. Currently, there are few data regarding the potential role of detoxification systems of GDP in PD. In this study, the role of glyoxalase 1 (Glo1), the major detoxification pathway for dicarbonyl-derived GD such as methylglyoxal (MG) and glyoxal (Gx), was investigated in vivo using heterozygous knock-down mice for Glo1 (Glo1(-/+)).
Wild-type (WT) and Glo1(-/+) mice were repeatedly treated with PDF containing low and high amounts of GDP, particularly with respect to the content of dicarbonyls. After 12 weeks of treatment with PDF, peritoneal damage and function were evaluated.
Glo1(-/+) mice treated with PDF showed increased formation of advanced glycation endproduct (AGE) when compared with WT mice, particularly the Gx-derived AGE, carboxymethyl-lysine. This was associated with increased inflammation, neovascularization, increased peritoneal fibrosis and impaired peritoneal function.
This study suggests a pivotal and underestimated role for Glo1 as a detoxifying enzyme in GDP-associated peritoneal toxicity in PD. The indirect and direct modulation of Glo1 may therefore offer a new therapeutic option in prevention of GDP-induced peritoneal damage in PD.
腹膜透析(PD)受到腹膜纤维化和超滤失败的限制。这部分是由于热灭菌导致腹膜透析液(PDF)中存在高浓度的葡萄糖降解产物(GDPs)。长期腹膜透析的现有研究主要涉及GDPs诱导的毒性以及降低GDPs细胞负担的治疗策略的开发。目前,关于GDP解毒系统在腹膜透析中的潜在作用的数据很少。在本研究中,使用Glo1杂合敲除小鼠(Glo1(-/+))在体内研究了乙二醛酶1(Glo1)的作用,Glo1是二羰基衍生的GDP(如甲基乙二醛(MG)和乙二醛(Gx))的主要解毒途径。
野生型(WT)和Glo1(-/+)小鼠反复接受含有低量和高量GDP的PDF治疗,特别是关于二羰基的含量。用PDF治疗12周后,评估腹膜损伤和功能。
与WT小鼠相比,用PDF治疗的Glo1(-/+)小鼠显示晚期糖基化终产物(AGE)的形成增加,特别是Gx衍生的AGE,羧甲基赖氨酸。这与炎症增加、新血管形成增加、腹膜纤维化增加和腹膜功能受损有关。
本研究表明Glo1作为一种解毒酶在腹膜透析中与GDP相关的腹膜毒性中起关键且被低估的作用。因此,对Glo1的间接和直接调节可能为预防腹膜透析中GDP诱导的腹膜损伤提供一种新的治疗选择。