Thomas S, Schenk U, Fischer F P, Mettang T, Passlick-Deetjen J, Kuhlmann U
Department of Nephrology, Robert-Bosch-Hospital, Stuttgart, Germany.
Am J Kidney Dis. 1997 Feb;29(2):246-53. doi: 10.1016/s0272-6386(97)90037-8.
Commercially available peritoneal dialysis fluids (PDFs) are known to impair peritoneal cellular defense mechanisms. We have investigated the influence of glucose polymer-containing PDFs on phagocytic function in vitro. Polymorphonuclear neutrophils (PMNLs) and monocytes (MNs) from 10 continuous ambulatory peritoneal dialysis patients and 10 healthy donors were incubated in PDFs containing either 7.5% icodextrin (glucose polymer) or 1.5% glucose at original pH and pH 7.4. Chemiluminescence response and H202 production were measured following stimulation with preopsonized Staphylococcus epidermidis or phorbol myristate acetate. Phagocytosis of radiolabeled bacteria and killing capacity of the cells were determined. A comparison of the impact of glucose polymer versus glucose-containing solutions at their original pH on the oxidative metabolism of the cells showed a highly significant difference (P < 0.0001) in favor of glucose polymers for H202 production of PMNLs (7.78 +/- 4.5 nmol cytochrome C reduction/10(6) cells/min v 1.11 +/- 0.67 nmol cytochrome C reduction/10(6) cells/min) and MNs (7.66 +/- 3.6 nmol cytochrome C reduction/10(6) cells/min v 1.29 +/- 0.86 nmol cytochrome C reduction/10(6)cells/min). Correspondingly, PMNLs and MNs incubated in glucose polymers showed a significantly higher chemiluminescence response irrespective of the stimulant used (P < 0.0001). Applying the killing assay on PMNLs also revealed a significantly higher percentage of inactivated bacteria (45.5% +/- 11.0% v 29.2% +/- 15.5%; P < 0.05). After adjustment of pH to 7.4, a significant difference could only be found for H202 production of PMNLs in favor of glucose polymers (16.73 +/- 6.98 nmol cytochrome C reduction/10(6) cells/min v 11.65 +/- 5.37 nmol cytochrome C reduction/10(6) cells/min; P < 0.05). In addition, we compared the glucose-polymer solution to an otherwise equally composed equiosmolar solution that contained 0.274% glucose instead of glucose polymers. No significant differences were detected with any of the tests applied. Our data suggest that glucose polymer solutions are comparatively less suppressive to phagocytic function than currently used glucose-containing PDFs. This effect may be attributed to the low osmolarity of these solutions.
已知市售腹膜透析液（PDFs）会损害腹膜细胞防御机制。我们研究了含葡萄糖聚合物的PDFs对体外吞噬功能的影响。将10名持续性非卧床腹膜透析患者和10名健康供者的多形核中性粒细胞（PMNLs）和单核细胞（MNs）在含有7.5%艾考糊精（葡萄糖聚合物）或1.5%葡萄糖的PDFs中，于初始pH值和pH 7.4条件下孵育。在用预调理的表皮葡萄球菌或佛波酯肉豆蔻酸酯刺激后，测量化学发光反应和H2O2生成量。测定放射性标记细菌的吞噬作用和细胞的杀伤能力。比较葡萄糖聚合物与含葡萄糖溶液在初始pH值时对细胞氧化代谢的影响，结果显示，对于PMNLs的H2O2生成（7.78±4.5 nmol细胞色素C还原/10(6)细胞/分钟对1.11±0.67 nmol细胞色素C还原/10(6)细胞/分钟）和MNs的H2O2生成（7.66±3.6 nmol细胞色素C还原/10(6)细胞/分钟对1.29±0.86 nmol细胞色素C还原/10(6)细胞/分钟），有利于葡萄糖聚合物的差异具有高度显著性（P<0.0001）。相应地，无论使用何种刺激物，在葡萄糖聚合物中孵育的PMNLs和MNs均显示出显著更高的化学发光反应（P<0.0001）。对PMNLs进行杀伤试验也显示，失活细菌的百分比显著更高（45.5%±11.0%对29.2%±15.5%；P<0.05）。将pH值调至7.4后，仅在PMNLs的H2O2生成方面发现有利于葡萄糖聚合物的显著差异（16.73±6.98 nmol细胞色素C还原/10(6)细胞/分钟对11.65±5.37 nmol细胞色素C还原/10(6)细胞/分钟；P<0.05）。此外，我们将葡萄糖聚合物溶液与另一种等渗溶液进行比较，该等渗溶液含有0.274%葡萄糖而非葡萄糖聚合物。应用的任何测试均未检测到显著差异。我们的数据表明，与目前使用的含葡萄糖PDFs相比，葡萄糖聚合物溶液对吞噬功能的抑制作用相对较小。这种效应可能归因于这些溶液的低渗透压。
