Division of Nephrology and Hypertension, Hannover Medical School, Hannover, Germany.
German Center for Lung Research, Hannover Medical School, Hannover, Germany.
Eur J Immunol. 2021 Feb;51(2):354-367. doi: 10.1002/eji.202048733. Epub 2020 Sep 30.
Peritoneal dialysis (PD) employs hypertonic glucose to remove excess water and uremic waste. Peritoneal membrane failure limits its long-term use. T-cell cytokines promote this decline. T-cell differentiation is critically determined by the microenvironment. We here study how PD-range hypertonic glucose regulates T-cell polarization and IL-17 production. In the human peritoneal cavity, CD3 cell numbers increased in PD. Single cell RNA sequencing detected expression of T helper (Th) 17 signature genes RORC and IL23R. In vitro, PD-range glucose stimulated spontaneous and amplified cytokine-induced Th17 polarization. Osmotic controls l-glucose and d-mannose demonstrate that induction of IL-17A is a substance-independent, tonicity dose-dependent process. PD-range glucose upregulated glycolysis and increased the proportion of dysfunctional mitochondria. Blockade of reactive-oxygen species (ROS) prevented IL-17A induction in response to PD-range glucose. Peritoneal mesothelium cultured with IL-17A or IL17F produced pro-inflammatory cytokines IL-6, CCL2, and CX3CL1. In PD patients, peritoneal IL-17A positively correlated with CX3CL1 concentrations. PD-range glucose-stimulated, but neither identically treated Il17a Il17f nor T cells cultured with the ROS scavenger N-acetylcysteine enhanced mesothelial CX3CL1 expression. Our data delineate PD-range hypertonic glucose as a novel inducer of Th17 polarization in a mitochondrial-ROS-dependent manner. Modulation of tonicity-mediated effects of PD solutions may improve membrane survival.
腹膜透析(PD)利用高渗葡萄糖来去除多余的水分和尿毒症废物。腹膜衰竭限制了其长期使用。T 细胞细胞因子促进了这种下降。T 细胞分化受到微环境的严格控制。我们在这里研究 PD 范围高渗葡萄糖如何调节 T 细胞极化和 IL-17 产生。在人类腹膜腔中,CD3 细胞数量在 PD 中增加。单细胞 RNA 测序检测到 T 辅助(Th)17 特征基因 RORC 和 IL23R 的表达。在体外,PD 范围的葡萄糖刺激自发和放大细胞因子诱导的 Th17 极化。渗透控制 l-葡萄糖和 d-甘露糖表明,诱导 IL-17A 是一种物质独立、渗透压剂量依赖的过程。PD 范围的葡萄糖上调糖酵解并增加功能失调线粒体的比例。活性氧物质(ROS)的阻断可防止 PD 范围葡萄糖对 IL-17A 的诱导。用 IL-17A 或 IL17F 培养的腹膜间皮细胞产生促炎细胞因子 IL-6、CCL2 和 CX3CL1。在 PD 患者中,腹膜 IL-17A 与 CX3CL1 浓度呈正相关。PD 范围葡萄糖刺激,但 Il17a Il17f 或用 ROS 清除剂 N-乙酰半胱氨酸培养的 T 细胞均未增强间皮细胞 CX3CL1 表达。我们的数据描绘了 PD 范围高渗葡萄糖作为一种新型的 Th17 极化诱导剂,其方式为线粒体 ROS 依赖性。调节 PD 溶液的渗透压介导的影响可能会改善膜的存活。