Kaname S, Hirahara I, Ishibashi Y, et al.
High GDPs Solution Induces Peritoneal Fibrosis and Epithelial-
Mesenchymal Transition in New Rat PD Model.
ASN Annual Meeting -- San Francisco
J Am Soc Nephrol
(Nov) 18:690A 2007

Peritoneal fibrosis is a complication of peritoneal dialysis (PD) using
glucose-based dialysates, which contain small amounts of glucose degradation
products (GDPs). Here we developed new animal model for peritoneal fibrosis
induced by methylglyoxal (MGO), a major GDP in conventional solutions. Using
this model, we investigated pathogenic mechanism of peritoneal fibrosis,
focusing on possible involvement of epithelial-mesenchymal transition (EMT).
Male SD rats were exposed to 100 mL/kg of dialysates (pH 5.0) without
or with MGO (20 mM), or 10 mL/kg of 0.1% chlorhexidine gluconate (CHX) by
intraperitoneal injection for 21 days. Parietal peritoneum was obtained to
perform immunohistochemistry and analyze mRNA expression by RT-PCR. Matrix
metalloproteinase (MMP) levels were evaluated by zymography, and
concentrations of TGF-
and VEGF determined by
EIA. The MGO-treated rats showed peritoneal thickening and fibrosis,
associated with increased membrane permeability by peritoneal equilibration
test. The mRNA expression of type I collagen, TGF-
, MMP-2, VEGF and RAGE was increased, and concentrations of MMP-2,
TGF-
and VEGF in peritoneal fluids were
elevated. Moreover, mRNA expression of snail, marker of EMT, was
significantly increased, and immunohistochemistry revealed that some of the
cytokeratin-positive mesothelial cells showed
-
SMA statining. AGE was accumulated in the surface including mesothelial
cells. In contrast, peritoneal mesothelial cells were almost absent and snail
was not upregulated in CHX-treated rats, although marked peritoneal
thickening was seen.
These results show that MGO-treated rat model
mimics peritoneal changes during long-term PD rather than standard CHX model,
and it was suggested that repeated treatment with GDPs may cause peritoneal
fibrosis possibly by inducing EMT for mesothelial cells.

© Copyright 2007-2008, American Society of
Nephrology. Reproduced with permission.
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