Yamakawa Yuki, Mihara Taiki, Hori Masatoshi
Department of Veterinary Pharmacology, Graduate School of Agriculture and Life Sciences, The University of Tokyo, Tokyo, Japan.
Neurogastroenterol Motil. 2025 Oct;37(10):e70068. doi: 10.1111/nmo.70068. Epub 2025 May 2.
Peritoneal dialysis (PD) is a renal replacement therapy approach to treat end-stage renal failure. However, complications such as gastrointestinal dysmotility occur in patients undergoing PD, and the mechanisms underlying these complications have not been elucidated. We hypothesized that inflammation and dysfunction of the interstitial cells of Cajal (ICC) contribute to the PD-induced gastrointestinal dysmotility.
Mice were intraperitoneally administered a dialysate containing methylglyoxal (40 mM) every other day for 2 weeks to mimic the gastrointestinal complications in patients undergoing long-term PD. The gastrointestinal transit capacity was evaluated using fluorescent dyes that were forcibly administered orally. To evaluate the inflammation and function of the ICC in the intestinal muscles, we performed real-time polymerase chain reaction and immunohistochemical staining and measured spontaneous contractions ex vivo.
The intestinal transit capacity was significantly reduced in the methylglyoxal-treated group compared to that in the control group. In the inflammatory evaluation, the number of neutrophils and macrophages in the intestinal muscles significantly increased in the methylglyoxal-treated group compared to the control group. Moreover, the mRNA expression levels of Tnf, Il1b, and Il6 were upregulated in the intestinal muscle from the methylglyoxal-treated group. The mRNA expression of Kit, an interstitial cell of Cajal marker, was significantly decreased in the methylglyoxal-treated group. In addition, the frequency of spontaneous contractions, an index of ICC function, was decreased in the methylglyoxal-treated group.
Our data suggest that the PD-induced gastrointestinal dysmotility might be due to inflammation and dysfunction of the ICC in intestinal muscles.
腹膜透析(PD)是治疗终末期肾衰竭的一种肾脏替代治疗方法。然而,接受PD治疗的患者会出现诸如胃肠动力障碍等并发症,而这些并发症背后的机制尚未阐明。我们推测, Cajal间质细胞(ICC)的炎症和功能障碍导致了PD引起的胃肠动力障碍。
每隔一天给小鼠腹腔注射含有甲基乙二醛(40 mM)的透析液,持续2周,以模拟长期接受PD治疗患者的胃肠道并发症。使用经口强制给予的荧光染料评估胃肠运输能力。为了评估肠道肌肉中ICC的炎症和功能,我们进行了实时聚合酶链反应和免疫组织化学染色,并测量了离体的自发收缩。
与对照组相比,甲基乙二醛处理组的肠道运输能力显著降低。在炎症评估中,与对照组相比,甲基乙二醛处理组肠道肌肉中的中性粒细胞和巨噬细胞数量显著增加。此外,甲基乙二醛处理组肠道肌肉中Tnf、Il1b和Il6的mRNA表达水平上调。Cajal间质细胞标志物Kit的mRNA表达在甲基乙二醛处理组中显著降低。此外,作为ICC功能指标的自发收缩频率在甲基乙二醛处理组中降低。
我们的数据表明,PD引起的胃肠动力障碍可能是由于肠道肌肉中ICC的炎症和功能障碍所致。