Hain H, Jörres A, Kögel B, Mahiout A, Gahl G M, Kessel M
Department of Internal Medicine, Freie Universität Berlin, Universitätsklinikum Rudolf-Virchow, Seindort Charlottenburg, West Germany.
ASAIO Trans. 1988 Jul-Sep;34(3):429-32.
Interleukin-1 (Il-1), prostaglandins, and leukotrienes have been identified as inflammatory parameters in the setting of peritoneal dialysis. Recently, it was postulated that chronic overstimulation of peritoneal macrophages (PM) may result in fibrosis and loss of ultrafiltration. The aim of the present study was to investigate whether alternative osmotic agents (polyglucose, amino acids, glycerol, bicarbonate/glucose, gelatine, hydroxyethyl starch) provoke greater eicosanoid release by PMs than glucose. Fifty milliliters of sterile dialysate containing different osmotic agents were injected intraperitoneally into nonuremic guinea pigs. After 4 hours of dwell time, prostaglandin E2 (PGE2), thromboxane B2 (TXB2), and leukotriene B4 (LTB4) production was analyzed in peritoneal effluents using specific radioimmunoassays (RIA) after liquid extraction. Cyclooxygenase products were generated with all osmotic agents: PGE2 concentrations ranged from 0.9 to 2.8 ng/4h, and TXB2 levels ranged from 39 to 49 ng/4h. In addition, the lipoxygenase product LTB4 was found in concentrations between 1.8 and 3.5 ng/4h. There were no significant differences in eicosanoid release among the osmotic agents. Thus, in this experimental setting, the capacity of PM to release inflammatory mediators did not correlate with the chemical composition of the dialysis solutions.
白细胞介素-1(Il-1)、前列腺素和白三烯已被确定为腹膜透析时的炎症参数。最近有推测认为,腹膜巨噬细胞(PM)的慢性过度刺激可能导致纤维化和超滤功能丧失。本研究的目的是调查替代渗透剂(聚葡萄糖、氨基酸、甘油、碳酸氢盐/葡萄糖、明胶、羟乙基淀粉)是否比葡萄糖更能促使PM释放类花生酸。将含有不同渗透剂的50毫升无菌透析液腹腔内注射到非尿毒症豚鼠体内。在驻留4小时后,使用液体萃取后的特异性放射免疫分析法(RIA)分析腹膜流出液中前列腺素E2(PGE2)、血栓素B2(TXB2)和白三烯B4(LTB4)的产生情况。所有渗透剂都能产生环氧化酶产物:PGE2浓度范围为0.9至2.8纳克/4小时,TXB2水平范围为39至49纳克/4小时。此外,还发现脂氧合酶产物LTB4的浓度在1.8至3.5纳克/4小时之间。不同渗透剂之间类花生酸释放没有显著差异。因此,在本实验环境中,PM释放炎症介质的能力与透析液的化学成分无关。