van Bronswijk H, Verbrugh H A, Heezius H C, van der Meulen J, Oe P L, Verhoef J
Department of Medicine, Free University of Amsterdam, The Netherlands.
Eur J Clin Microbiol Infect Dis. 1988 Jun;7(3):368-73. doi: 10.1007/BF01962339.
The ability of polymorphonuclear leukocytes, monocytes and peritoneal macrophages to mount a respiratory burst in continuous ambulatory peritoneal dialysis (CAPD) fluids was tested in a phorbol-myristate acetate stimulated chemiluminescence assay. Fresh CAPD fluids depressed the chemiluminescence response of all three types of phagocytes tested to less than 18% of their chemiluminescence response in control buffer. When tested in spent CAPD fluids the suppression of chemiluminescence was 30-32%. Oxygen consumption of polymorphonuclear leukocytes was depressed in fresh CAPD fluids to below 40%. Both phagocytosis of Escherichia coli by and bactericidal capacity of polymorphonuclear leukocytes and monocytes were suppressed in fresh CAPD fluids but not in spent effluents. The influence of acidic pH and hyperosmolality on phagocytic functions were studied separately by modifying the acidity or the glucose content of the control buffer. pH values below 6.0 significantly inhibited chemiluminescence but not phagocytosis. Under hypertonic conditions, both phagocytosis and chemiluminescence were inhibited. We conclude that the currently available CAPD solutions are beyond the limits of acid and osmotic tolerance of human phagocytic cells, and may thus compromise the peritoneal defenses of CAPD patients.
在佛波醇-肉豆蔻酸酯乙酸盐刺激的化学发光试验中，检测了多形核白细胞、单核细胞和腹膜巨噬细胞在持续性非卧床腹膜透析（CAPD）液中产生呼吸爆发的能力。新鲜的CAPD液使所检测的三种吞噬细胞的化学发光反应降低至对照缓冲液中其化学发光反应的18%以下。在用过的CAPD液中进行检测时，化学发光的抑制率为30%-32%。新鲜CAPD液中多形核白细胞的耗氧量降低至40%以下。新鲜CAPD液中多形核白细胞和单核细胞对大肠杆菌的吞噬作用及杀菌能力均受到抑制，但用过的流出液中则未受抑制。通过改变对照缓冲液的酸度或葡萄糖含量，分别研究了酸性pH值和高渗对吞噬功能的影响。pH值低于6.0可显著抑制化学发光，但不抑制吞噬作用。在高渗条件下，吞噬作用和化学发光均受到抑制。我们得出结论，目前可用的CAPD溶液超出了人类吞噬细胞的酸和渗透压耐受极限，因此可能损害CAPD患者的腹膜防御功能。
