Yang Chih-Yu, Chau Yat-Pang, Chen Ann, Lee Oscar Kuang-Sheng, Tarng Der-Cherng, Yang An-Hang
Chih-Yu Yang, Der-Cherng Tarng, Division of Nephrology, Department of Medicine, Taipei Veterans General Hospital, Taipei 11217, Taiwan.
World J Nephrol. 2017 May 6;6(3):111-118. doi: 10.5527/wjn.v6.i3.111.
Long-term exposure to bioincompatible peritoneal dialysis (PD) solutions frequently results in peritoneal fibrosis and ultrafiltration failure, which limits the life-long use of and leads to the cessation of PD therapy. Therefore, it is important to elucidate the pathogenesis of peritoneal fibrosis in order to design therapeutic strategies to prevent its occurrence. Peritoneal fibrosis is associated with a chronic inflammatory status as well as an elevated oxidative stress (OS) status. Beyond uremia , OS also results from chronic exposure to high glucose load, glucose degradation products, advanced glycation end products, and hypertonic stress. Therapy targeting the cannabinoid (CB) signaling pathway has been reported in several chronic inflammatory diseases with elevated OS. We recently reported that the intra-peritoneal administration of CB receptor ligands, including CB receptor antagonists and CB receptor agonists, ameliorated dialysis-related peritoneal fibrosis. As targeting the CB signaling pathway has been reported to be beneficial in attenuating the processes of several chronic inflammatory diseases, we reviewed the interaction among the cannabinoid system, inflammation, and OS, through which clinicians ultimately aim to prolong the peritoneal survival of PD patients.
长期接触生物不相容的腹膜透析（PD）溶液常常会导致腹膜纤维化和超滤失败，这限制了PD治疗的长期使用并导致其停止。因此，阐明腹膜纤维化的发病机制对于设计预防其发生的治疗策略很重要。腹膜纤维化与慢性炎症状态以及氧化应激（OS）状态升高有关。除了尿毒症，OS还源于长期暴露于高糖负荷、葡萄糖降解产物、晚期糖基化终产物和高渗应激。在几种OS升高的慢性炎症性疾病中，已经报道了针对大麻素（CB）信号通路的治疗方法。我们最近报道，腹腔内给予CB受体配体，包括CB受体拮抗剂和CB受体激动剂，可改善与透析相关的腹膜纤维化。由于据报道靶向CB信号通路在减轻几种慢性炎症性疾病的进程中是有益的，我们综述了大麻素系统、炎症和OS之间的相互作用，临床医生最终旨在通过这种相互作用延长PD患者的腹膜存活时间。
