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Breborowicz A, Wieczorowska K, Witowski J, Martis L, Oreopoulos DG. Phosphatidylcholine and Chondroitin Sulphate in Peritoneal Dialysis Fluids to Preserve Membrane Function. Perit Dial Int 2020. [DOI: 10.1177/089686089401403s25] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
| | | | - Janusz Witowski
- Department of Pathophysiology, Medical School, Poznan, Poland
| | - Leo Martis
- Baxter Healthcare, Round Lake, Illinois, U.S.A
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2
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Affiliation(s)
- John F. Maher
- Department of Medicine Uniformed Services University of the Health Sciences 4301 Jones Bridge Road Bethesda, Maryland 20889–4799 U.S.A
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3
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Di Paolo N, Garosi G, Biagioli M. Effects of Dialysis Fluids on Cultured Mesothelial Cells. Perit Dial Int 2020. [DOI: 10.1177/089686089401403s03] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Nicola Di Paolo
- Nephrology Department, Regional Hospital of Siena, Siena, Italy
| | - Guido Garosi
- Nephrology Department, Regional Hospital of Siena, Siena, Italy
| | - Marina Biagioli
- Nephrology Department, Regional Hospital of Siena, Siena, Italy
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4
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Hjelle JT, Miller-Hjelle MA, Dobbie JW. The Biology of the Mesothelium during Peritoneal Dialysis. Perit Dial Int 2020. [DOI: 10.1177/089686089501507s03] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Substantial derangements of mesothelial biology are observed during experimental simulations of dialysis conditions, inferred from the content of human dialysis effluent and visualized by microscopy of human mesothelial biopsies. Canosmotically active solutions be made biocompatible with the osmoregulatory system of the mesothelium? Can the contributions of the mesothelium to host defenses against inflammation and/or infection be supported during CAPD? Do underlying metabolic derangements present in various kidney diseases and end-stage renal disease, regardless of cause, require customized CAPD protocols and solutions? Use of dialysis solutions less directly toxic to the mesothelium is a necessary step toward some day manipulating peritoneal biology by pharmacological and therapeutic modalities.
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Affiliation(s)
- J. Thomas Hjelle
- Basic Sciences, University of Illinois College of Medicine at Peoria, Peoria, Illinois, U.S.A
| | - Marcia A. Miller-Hjelle
- Basic Sciences, University of Illinois College of Medicine at Peoria, Peoria, Illinois, U.S.A
| | - James W. Dobbie
- The Royal Infirmary, The University of Edinburgh, Edinburgh, Scotland
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5
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Breborowicz A, Oreopoulos DG. Physiological Approaches to Increase Biocompatibility of Peritoneal Dialysis. Perit Dial Int 2020. [DOI: 10.1177/089686089501507s11] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Andrzej Breborowicz
- Department of Pathophysiology, Medical School Poznan, Poland
- Division of Nephrology, University of Toronto, Toronto, Canada
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6
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Abstract
Extensive experience with chronic peritoneal dialysis has identified a series of functional and anatomical pathologic changes in the peritoneal membrane thought to be the result of repeated insults from bioincompatible solutions. Laboratory and clinical findings from recent investigations often conflict and are difficult to interpret due to variations in methodologies, animal models, study designs, and data analyses. The principal pathophysiologic mechanisms identified thus far are oxidative stress, inflammation, and their consequences. Many substances used to neutralize the action of these insults, prevent formation of toxic compounds, or directly alter solute and water transport to improve peritoneal membrane performance have been studied. We herein review the most promising of these substances or those that deserve attention because their use has contributed to better understanding of peritoneal pathophysiology. Most peritoneal solution additives have proved useless due to their toxicity and undesirable effects, ineffectiveness, or manufacturing limitations. A few substances deserve more attention, particularly those capable of restoring negatively charged membrane sites, those that somehow improve permselectivity, scavengers of oxidants, and advanced glycation end-product inhibitors and breakers. Recent publications on clinical experience with neutral pH, low glucose degradation product (GDP) peritoneal solutions, although few and preliminary, are most encouraging. The virtual elimination of GDPs in these novel solutions will probably preclude the need for GDP scavengers and inhibitors. Nonetheless, there is room for further significant improvement in solution biocompatibility and for compounds that may restore peritoneal function.
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Affiliation(s)
- Jose A. Diaz-Buxo
- Home Therapies Development, Fresenius Medical Care North America, Lexington Massachusetts, USA
| | - Lazaro Gotloib
- Department of Nephrology & Hypertension and Research Center for Experimental Nephrology, Ha'Emek Medical Center, Afula, Israel
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7
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Hekking LH, van den Born J. Feasibility of Mesothelial Transplantation during Experimental Peritoneal Dialysis and Peritonitis. Int J Artif Organs 2018; 30:513-9. [PMID: 17628852 DOI: 10.1177/039139880703000609] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The mesothelial cell layer lining the peritoneum orchestrates peritoneal homeostasis. Continuous exposure to peritoneal dialysis fluids and episodes of peritonitis may damage the monolayer irreversibly, eventually leading to adhesion formation and fibrosis/sclerosis of the peritoneum. Autologous mesothelial cell transplantation is thought to be one of the options to reduce dysfunction of the peritoneal membrane. In this article we will review the mesothelial cell transplantation experiments performed in the field of peritoneal dialysis and peritonitis. In addition we will focus on the trouble shooting using cultured autologous mesothelial cells for transplantation.
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Affiliation(s)
- L H Hekking
- Department of Cellular Architecture and Dynamics, University of Utrecht, Utrecht, The Netherlands
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Mutsaers SE, Prêle CM, Lansley SM, Herrick SE. The Origin of Regenerating Mesothelium: A Historical Perspective. Int J Artif Organs 2018; 30:484-94. [PMID: 17628849 DOI: 10.1177/039139880703000606] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Bichat first described the mesothelium in 1827 but despite its early discovery, it has only been in recent years that its importance both in health and disease has been realised. One area still poorly understood is that of the mechanisms regulating mesothelial repair. Mesothelial cells are derived from the mesoderm but express many epithelial characteristics. However, mesothelium does not heal in the same way as other epithelial-like cells. Epithelium heals by centripetal migration, with cells at the edge of the wound proliferating and migrating into the injured area. Hertzler in 1919 noted that both large and small peritoneal injuries healed within the same time frame, concluding that the mesothelium could not heal solely by centripetal migration. The exact mechanisms involved in mesothelial regeneration following injury are controversial with a number of proposals suggested to explain the origin of the regenerating cells. This review will examine these proposals and give some insights into the likely mechanisms involved.
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Affiliation(s)
- S E Mutsaers
- Anatomical Pathology, PathWest Laboratory Medicine WA, Nedlands 6009, WA, Australia.
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Gotloib L, Gotloib LC, Khrizman V. The use of Peritoneal Mesothelium as a Potential Source of Adult Stem Cells. Int J Artif Organs 2018; 30:501-12. [PMID: 17628851 DOI: 10.1177/039139880703000608] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
At the dawn of the 21st century, classical curative medicine is being challenged by the fact that efforts to fight and prevent not a few diseases, are in many circumstances, beyond the power of the pharmacological armamentarium of the medical profession. On the other hand, replacement of lost function by mechanical or biophysical devices, or even by organ transplantation, prolongs life but generally derives in new and, at times, unsolvable problems. Regenerative therapy using stem cells began a revolutionary trend that may well change both the therapeutic approach to not a few of the diseases resulting from failing organs, as well as the fate and quality of life of millions of patients. The presence of pluripotent mesenchymal cells in the mesothelial monolayer as well as in the submesothelial connective tissue raises the possibility of using the peritoneal mesothelium in regenerative therapies. This perception of the problem is also based on observations made in humans as well as in laboratory animals showing bone, bone marrow, cartilaginous tissue, glomerular-like structures and creation of blood conducts, pathological situations (mesothelioma, sclerosing peritonitis), or after in vivo or ex vivo experimental interventions. The main concept emerging from this information is that peritoneal mesothelial cells are endowed with such a degree of plasticity that, if placed in the appropriate micro-environment, they have a remarkable potential to generate other mesenchymal-derived cell lines. Intensive research is required to define the best environmental conditions to take advantage of this plasticity and make the peritoneal mesothelium an actual option to be applied in regenerative medicine.
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Affiliation(s)
- L Gotloib
- Laboratory for Experimental Nephrology, Ha'Emek Medical Center, Afula 18101, Israel.
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Di Paolo N, Sacchi G, Del Vecchio MT, Nicolai GA, Brardi S, Garosi G. State of the Art on Autologous Mesothelial Transplant in Animals and Humans. Int J Artif Organs 2018; 30:456-76. [PMID: 17628847 DOI: 10.1177/039139880703000604] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Sixteen years ago rabbit and human mesothelial cells were successsfully cultured and autoimplanted. The aim of the study was merely to demostrate that mesothelial implant was possible and interesting not only in peritoneal dialysis, but also in the vaster field of medicine and surgery concerning all the mesothelial districts of the body. The aim of this paper is to recollect the steps which have led to autolougous mesothelial transplantation and verify if the tecnique has been validated and adopted by others. Review of the literature published in the last 15 years shows that intraperitoneal transplantation of mesothelial cells has been effective in reducing the formation of peritoneal adhesions, and in remodeling the area of mesothelial denudation. New studies on the mesothelial cell opened the way to costruction of transplantable tissue-engineered artificial peritoneum, to the utilization of mesothelial progenitor cells and to find simple metods to collect autologous mesothelial cells. Finally mesothelial trasnsplantation may represent a new neovascular therapy in the prevention and treatment of ischemic coronaric heart disease.
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Affiliation(s)
- N Di Paolo
- Department of Nephrology, Dialysis and Kidney Transplant, Siena University Hospital, Siena, Italy.
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11
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Kawanishi K. Mesothelial cell transplantation: history, challenges and future directions. Pleura Peritoneum 2016; 1:135-143. [PMID: 30911617 PMCID: PMC6419540 DOI: 10.1515/pp-2016-0014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Accepted: 08/10/2016] [Indexed: 12/20/2022] Open
Abstract
Mesothelial cells line the surface of the pleura, pericardium, peritoneum and internal reproductive organs. One of their main functions is to act as a non-adhesive barrier to protect against physical damage, however, over the past decades their physiological and pathological properties have been revealed in association with a variety of conditions and diseases. Mesothelium has been used in surgical operations in clinical settings, such as omental patching for perforated peptic ulcers and in glutaraldehyde-treated autologous pericardium for aortic valve reconstruction. Various methods for mesothelial cell transplantation have also been established and developed, particularly within the area of tissue engineering, including scaffold and non-scaffold cell sheet technologies. However, the use of mesothelial cell transplantation in patients remains challenging, as it requires additional operations under general anesthesia in order to obtain enough intact cells for culture. Moreover, the current methods of mesothelial cell transplantation are expensive and are not yet available in clinical practice. This review firstly summarizes the history of the use of mesothelial cell transplantation in tissue engineering, and then critically discusses the barriers for the clinical application of mesothelial cell transplantation. Finally, the recent developments in xenotransplantation technologies are discussed to evaluate other feasible alternatives to mesothelial cell transplantation.
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Affiliation(s)
- Kunio Kawanishi
- Department of Cellular and Molecular Medicine, University of California, San Diego,9500 Gilman Drive, La Jolla, CA 92093–0687, USA
- Department of Surgical Pathology, Tokyo Women’s Medical University, 8–1, Kawada-cho, Shinjuku-ku, 162–8666, Tokyo, Japan
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Kitamura S, Horimoto N, Tsuji K, Inoue A, Takiue K, Sugiyama H, Makino H. The selection of peritoneal mesothelial cells is important for cell therapy to prevent peritoneal fibrosis. Tissue Eng Part A 2013; 20:529-39. [PMID: 24007428 DOI: 10.1089/ten.tea.2013.0130] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Long-term peritoneal dialysis (PD) causes chronic peritoneal damage. Peritoneal mesothelial cells (PMCs) play an important role in peritoneal function. We investigated the possibility of cell therapy using the PMCs to prevent peritoneal damage in PD patients. We harvested human PMCs from the PD effluent of PD patients. The PMCs were separated based on morphological characteristics into epithelial-like (Epi) cells and fibroblast-like (Fib) cells by the limiting dilution method. We transplanted these cells into nude mice whose parietal and visceral peritoneum were scratched by mechanical scraping. The transplanted cells were detected at the parietal and visceral peritoneum. Compared with the positive control, the Epi cell therapy group showed very few adhesions and exhibited no thickening of the parietal and visceral peritoneum. However, the group with Fib cell therapy could not inhibit peritoneal adhesion and thickening. In addition, hepatocyte growth factor was expressed by the grafted Epi cells but not Fib cells. Fib cells expressed vascular endothelial growth factor stronger than Epi cells. These two types of cells from the same patient showed different characteristics and effects for cell therapy. These findings suggest that the PMCs from the PD patient showed different characteristics, such as Epi cells and Fib cells, and the selection of PMCs is important for cell therapy on the point of not only the direct cellular interactions but also cytokine secretion from the grafted cells. Furthermore, the differences in the morphological cell characteristics may influence their role in peritoneal regeneration.
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Affiliation(s)
- Shinji Kitamura
- Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences , Okayama, Japan
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Paolo ND, Nicolai GA, Garosi G. The Peritoneum: From Histological Studies to Mesothelial Transplant through Animal Experimentation. Perit Dial Int 2008. [DOI: 10.1177/089686080802805s02] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Nicola Di Paolo
- Nephrology, Dialysis and Transplantation Unit, Azienda
Universitaria Ospedaliera Senese, Siena, Italy
| | - Giulia A. Nicolai
- Nephrology, Dialysis and Transplantation Unit, Azienda
Universitaria Ospedaliera Senese, Siena, Italy
| | - Guido Garosi
- Nephrology, Dialysis and Transplantation Unit, Azienda
Universitaria Ospedaliera Senese, Siena, Italy
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15
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Ronco C. Mesotheliology: a new area of research? Int J Artif Organs 2007; 30:453-5. [PMID: 17628846 DOI: 10.1177/039139880703000603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Asano T, Takazawa R, Yamato M, Kageyama Y, Kihara K, Okano T. Novel and simple method for isolating autologous mesothelial cells from the tunica vaginalis. BJU Int 2005; 96:1409-13. [PMID: 16287467 DOI: 10.1111/j.1464-410x.2005.05816.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To report the development of a new method of isolating autologous mesothelial cells from the tunica vaginalis that are easily obtained and generally free from the effects of abdominal cancer, and to investigate whether transplanting these mesothelial cells is effective in preventing postoperative adhesions. MATERIALS AND METHODS The tunica vaginalis was resected from male Lewis rats, and mesothelial cells were collected by enzymatic disaggregation. To investigate the efficacy of mesothelial cells in preventing adhesion, harvested cells were transplanted into a rat intestinal hernia adhesion model. RESULTS Cells isolated from the tunica vaginalis were homogenous, polygonal when confluent, expressed cytokeratin and vimentin, and the cell surface was covered with microvilli, which is the characteristic appearance of endogenous mesothelial cells. The transplantation of autologous mesothelial cell sheets reduced peritoneal adhesion. CONCLUSION We developed a new method of obtaining autologous mesothelial cells from the tunica vaginalis. These cells may provide a valuable option for treating patients at risk of postoperative adhesions.
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Affiliation(s)
- Touko Asano
- Department of Urology, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan.
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References. Perit Dial Int 2000. [DOI: 10.1177/089686080002003s08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Valle MT, Degl'Innocenti ML, Bertelli R, Facchetti P, Perfumo F, Fenoglio D, Kunkl A, Gusmano R, Manca F. Antigen-presenting function of human peritoneum mesothelial cells. Clin Exp Immunol 1995; 101:172-6. [PMID: 7621585 PMCID: PMC1553303 DOI: 10.1111/j.1365-2249.1995.tb02294.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Mesothelial cells (MC) from human peritoneal omentum fragments obtained during surgical insertion of peritoneal catheters for continuous peritoneal dialysis in end stage renal failure (ESRF) patients were cultured in vitro. MC exhibited a phenotype different from macrophages, but MHC class II molecules were well expressed. Therefore MC lines were tested for antigen-presenting capacity by pulsing with soluble antigens (tetanus toxoid and purified protein derivative (PPD)) or with a corpusculate antigen (Candida albicans bodies). Autologous peripheral blood mononuclear cells (PBMC) depleted of adherent monocytes and cloned T cells generated from an individual matched for the MHC class II antigen DR2 were used to test antigen-presenting function. MC effectively presented the soluble and corpusculate antigens to autologous and MHC-compatible allogeneic lymphocytes, indicating that they are endowed with both endocytic/phagocytic activity and with processing/presenting capacity. Preincubation of MC with human recombinant interferon-gamma (IFN-gamma) up-regulated MHC class II and intercellular adhesion molecule-1 (ICAM-1) expression, but the effect on antigen-presenting function was not consistent. Since MC are an important component of the peritoneal environment, they may participate, along with macrophages, in activation of specific T cells and in the generation of local cell-mediated immunity to various pathogens.
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Affiliation(s)
- M T Valle
- Department of Immunology, San Martino Hospital, University of Genoa, Italy
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Breborowicz A, Rodela H, Oreopoulos DG. Toxicity of osmotic solutes on human mesothelial cells in vitro. Kidney Int 1992; 41:1280-5. [PMID: 1614042 DOI: 10.1038/ki.1992.190] [Citation(s) in RCA: 122] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
We evaluated the effect of the various osmotic solutes on the growth rate of human mesothelial cells (HMC) in an in vitro culture. Glucose inhibited proliferation of HMC in a dose dependent way. At high glucose concentrations (60 mM, 90 mM) the effect was instant but at lower concentration (30 mM) decrease in the mesothelial cell proliferation was significant only after five days of incubation. Reversibility of the glucose effect was inversely proportional to exposure time to this solute. Mannitol and glycerol studied in similar concentrations as glucose decreased proliferation of the mesothelial cells less than glucose, whereas amino acid glycine had a similar effect to glucose. However, all osmotic solutes caused similar injury to mesothelial cells membrane as measured by release of LDH. These results suggest that the toxic effect of the osmotic solutes on proliferation of the mesothelial cells depends not only on the hyperosmolality but also on some metabolic effect(s). In an in vitro culture, HMC may provide a suitable model for the study of the toxic effect of dialysis fluid on peritoneal mesothelium.
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Affiliation(s)
- A Breborowicz
- Division of Nephrology, Toronto Western Hospital, Ontario, Canada
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Hjelle JT, Waters DC, Golinska BT, Steidley KR, Burmeister V, Caughey R, Ketel B, McCarroll DR, Olsson PJ, Prior RB. Autosomal recessive polycystic kidney disease: characterization of human peritoneal and cystic kidney cells in vitro. Am J Kidney Dis 1990; 15:123-36. [PMID: 2154094 DOI: 10.1016/s0272-6386(12)80509-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Renal cystic epithelia and peritoneal mesothelia from two humans with autosomal recessive polycystic kidney disease (ARPKD) were grown in culture. Cystic epithelial and mesothelial cells formed continuous monolayers in vitro. By electron microscopy, cystic renal cells exhibited a single apical cilium and numerous short, stubby microvilli, both in situ and in vitro. Mesothelial cells exhibited intra- and extracellular membrane-limited, lipid-filled vesicles and surface microvilli. Cystic kidney cells in vitro stained positive for lectins from Cancanavalia ensiformis (concanavalin A), Triticum vulgaris, Erythrina cristagalli, Ulex europeaus, and Arachis hypogaea. Immunocytochemical and lectin staining revealed the renal and peritoneal cells to be of collecting tubule and mesothelial origin, respectively. Both cell types showed large depositions of glycogen granules in the cytoplasm during propagation in certain culture media; in kidney cells, dibutyryl cyclic adenosine monophosphate (cAMP) abolished glycogen depositions. Glycogen deposition also was observed in liver tissue obtained by needle biopsy from one patient. No bacteria were cultured from nor endotoxin detected in the renal cyst fluid. Relative to serum, the cyst fluids contained low sodium, potassium, and chloride levels. Thus, cultured ARPKD cells demonstrate a number of characteristics that are different from cells derived from the autosomal dominant form of renal cystic disease (ADPKD).
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Affiliation(s)
- J T Hjelle
- Department of Basic Sciences, University of Illinois College of Medicine, Peoria 61656
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