Xie Xishao, Wang Junni, Xiang Shilong, Chen Zhimin, Zhang Xiaohui, Chen Jianghua
The Kidney Disease Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, 79 Qingchun Rd, Hangzhou, Zhejiang, 310003, People's Republic of China.
BMC Nephrol. 2019 Apr 11;20(1):128. doi: 10.1186/s12882-019-1284-3.
Mitochondrial DNA (mtDNA) released into extracellular subsequent to cell injury and death can promote inflammation in patients and animal models. However, the effects of peritoneal dialysate cell-free mtDNA on intraperitoneal inflammation and peritoneal solute transport rate (PSTR) in peritoneal dialysis (PD) patients remain unclear.
We select the incident patients who began PD therapy between January 1, 2009, and December 30, 2010. Peritoneal dialysate was collected at the time of peritoneal equilibration test. The cell-free mtDNA, IL-6, IL-17A, TNF-α and IFN-γ were measured. All patients were followed till December 2017. The results were compared with PSTR and patient survival.
One hundred and eighty-nine patients were included in the study. The average age was 47.1 ± 13.5 years, 55.6% of the patients were males. The average PSTR was 0.66 ± 0.12, the median dialysate mtDNA levels were 4325 copies/ul. The median concentrations of IL-6, IL-17A, TNF-α and IFN-γ were 25.9, 10.8, 25.8 and 17.9 pg/ml, respectively. We found that dialysate mtDNA was significantly correlated with PSTR (r = 0.461, P < 0.001), IL-6 (r = 0.568, P < 0.001), TNF-α (r = 0.454, P < 0.001) and IFN-γ (r = 0.203, P = 0.005). After adjustment for multiple covariates, dialysate mtDNA levels were independently correlated with IL-6 and PSTR. Dialysate mtDNA levels were not associated with patient survival.
We found that dialysate mtDNA levels correlated with the degree of intraperitoneal inflammatory status in PD patients. Peritoneal effluent mtDNA was an independent determinant of PSTR but did not affect patient survival.
细胞损伤和死亡后释放到细胞外的线粒体DNA（mtDNA）可在患者和动物模型中促进炎症反应。然而，腹膜透析（PD）患者腹透液中无细胞mtDNA对腹膜内炎症和腹膜溶质转运率（PSTR）的影响仍不清楚。
我们选取了2009年1月1日至2010年12月30日开始进行PD治疗的新发患者。在腹膜平衡试验时收集腹透液。检测无细胞mtDNA、白细胞介素-6（IL-6）、白细胞介素-17A（IL-17A）、肿瘤坏死因子-α（TNF-α）和干扰素-γ（IFN-γ）。所有患者随访至2017年12月。将结果与PSTR和患者生存率进行比较。
189例患者纳入研究。平均年龄为47.1±13.5岁，55.6%为男性。平均PSTR为0.66±0.12，腹透液mtDNA水平中位数为4325拷贝/微升。IL-6、IL-17A、TNF-α和IFN-γ的浓度中位数分别为25.9、10.8、25.8和17.9皮克/毫升。我们发现腹透液mtDNA与PSTR（r=0.461，P<0.001）、IL-6（r=0.568，P<0.001）、TNF-α（r=0.454，P<0.001）和IFN-γ（r=0.203，P=0.005）显著相关。在对多个协变量进行校正后，腹透液mtDNA水平与IL-6和PSTR独立相关。腹透液mtDNA水平与患者生存率无关。
我们发现腹透液mtDNA水平与PD患者腹膜内炎症状态程度相关。腹膜流出液mtDNA是PSTR的独立决定因素，但不影响患者生存率。
