Brulez H F, Dekker H A, Oe P L, Verbeelen D, ter Wee P M, Verbrugh H A
Department of Internal Medicine, Academic Hospital Vrije Universiteit, Amsterdam, The Netherlands.
Nephron. 1996;74(1):26-32. doi: 10.1159/000189277.
The biocompatibility of a 1.1% amino acid-containing peritoneal dialysis fluid (AA-PDF) was compared to that of a 2.27% glucose-based peritoneal dialysis fluid (G-PDF). Peritoneal macrophages (PMO), isolated from the peritoneal dialysis (PD) effluents of 10 chronic ambulatory PD patients, were tested for their phagocytosis capacity and peak chemiluminescence response. A subset of PMO was cultured for 24 h with and without lipopolysaccharide (LPS) to study the release of interleukin-1 beta (IL-1 beta) and 8 (IL-8). As control, the interleukin release by blood monocytes of healthy donors was tested. The opsonic activity of the PD effluent was tested as well. Compared to PMO isolated from G-PDF, PMO from AA-PDF showed a significantly better phagocytosis capacity. There was no difference in the peak chemiluminescence response between PMO from AA-PDF and G-PDF. The release of IL-1 beta by unstimulated PMO isolated from the two fluids did not differ. Compared to control monocytes, however, PMO from both fluids showed a considerable spontaneous release of IL-1 beta. When stimulated with LPS, IL-1 beta production by PMO from G-PDF exceeded that of PMO from AA-PDF (p < 0.002). The release of IL-8 by PMO from G-PDF was significantly higher in comparison with PMO from AA-PDF, both spontaneously and after stimulation with LPS (p < 0.02). The opsonic activity of undiluted and to 75% diluted effluents was significantly higher for G-PDF than for AA-PDF (p < 0.01). Thus, compared to the regularly used G-PDF, the phagocytosis capacity as measure for PMO function seems to be better preserved after in vivo exposure to AA-PDF. In addition, the higher release of IL-1 beta and IL-8 by PMO isolated from G-PDF suggests a stronger intra-abdominal activation of PMO, with G-PDF acting as a chemical inflammatory agent. Whether the lower opsonic activity of the AA-PDF is more important for biocompatibility than the other parameters is not clear. Therefore, it is concluded that, although macrophage function is better preserved, it is not proven that the 1.1% AA-PDF studied has an improved biocompatibility compared to 2.27% G-PDF.
将含1.1%氨基酸的腹膜透析液（AA-PDF）的生物相容性与含2.27%葡萄糖的腹膜透析液（G-PDF）的生物相容性进行了比较。从10例慢性非卧床腹膜透析患者的腹膜透析（PD）流出液中分离出腹膜巨噬细胞（PMO），检测其吞噬能力和化学发光峰值反应。将一部分PMO在有和没有脂多糖（LPS）的情况下培养24小时，以研究白细胞介素-1β（IL-1β）和8（IL-8）的释放。作为对照，检测了健康供体血液单核细胞的白细胞介素释放情况。还检测了PD流出液的调理活性。与从G-PDF中分离出的PMO相比，从AA-PDF中分离出的PMO显示出明显更好的吞噬能力。从AA-PDF和G-PDF中分离出的PMO的化学发光峰值反应没有差异。从两种液体中分离出的未刺激的PMO释放的IL-1β没有差异。然而，与对照单核细胞相比，来自两种液体的PMO都显示出相当数量的IL-1β自发释放。当用LPS刺激时，来自G-PDF的PMO产生的IL-1β超过了来自AA-PDF的PMO（p<0.002）。与来自AA-PDF的PMO相比，来自G-PDF的PMO自发释放和用LPS刺激后释放的IL-8明显更高（p<0.02）。G-PDF的未稀释和稀释至75%的流出液的调理活性明显高于AA-PDF（p<0.01）。因此，与常规使用的G-PDF相比，在体内接触AA-PDF后，作为PMO功能指标的吞噬能力似乎得到了更好的保留。此外，从G-PDF中分离出的PMO释放的IL-1β和IL-8较高，表明PMO在腹腔内的激活更强，G-PDF起到了化学炎症介质的作用。AA-PDF较低的调理活性对生物相容性是否比其他参数更重要尚不清楚。因此，得出的结论是，虽然巨噬细胞功能得到了更好的保留，但与2.27%的G-PDF相比，所研究的1.1%的AA-PDF具有改善的生物相容性这一点尚未得到证实。
