腹膜透析感染期过氧化物酶体增殖物激活受体γ水平的变化及意义

Effect of dialysis-induced peritonitis on peroxisome proliferator-activated receptor γ mRNA experession of peritoneal monocyte in peritoneal dialysis patients

目的探讨腹膜透析感染期过氧化物酶体增殖物激活受体γ水平的变化及意义。方法选择哈尔滨医科大学附属第一医院肾内科腹膜透析患者,分为实验组与对照组,应用RT-PCR对实验组和对照组腹膜透析液及外周抗凝血提取的巨噬细胞PPARγmRNA表达水平进行测定,ELISA测定外周血单核细胞TNF-α、IL-6水平。结果RT-PCR显示腹膜透析液及外周血单核细胞PPARγmRNA的表达水平,实验组第1天[分别为(0.52±0.06),(0.68±0.07)]均明显低于实验组第5天[分别为(0.66±0.09),(0.89±0.08)及对照组[分别为(0.68±0.08),(0.93±0.06)](P<0.01)。腹膜炎症初期,PPARγmRNA为低表达。ELISA测定外周抗凝血单核细胞TNF-α、IL-6水平,实验组第1天[分别为(20.16±11.26)ng/L,(26.89±13.46)ng/L]均明显高于实验组第5天[分别为(6.38±4.28)ng/L,(8.96±4.67)ng/L]及对照组[分别为(5.39±3.50)ng/L,(7.83±4.26)ng/L](P<0.01),与PPARγmRNA表达水平呈明显负相关。结论腹膜透析合并腹膜炎初期患者腹腔巨噬细胞PPARγmRNA低表达,PPARγ在腹腔局部免疫中可能有重要意义。

Objective To investigate the effect of dialysis-induced peritonitis onperoxisome proliferator-activated receptor（PPAR）-γ mRNA expression of peritoneal monocyte in peritoneal dialysis patients.Methods Thirty-nine peritoneal dialysis patients were divided into experimental group（EG, n=19） and control group （CG, n=20）, The PPAR-γ gene expression of peripheral blood（PB） monocyte and peritoneal dialysis effluent （PDE） was examined by RT-PCR. The TNF- α and IL-6 concentrations of peripheral blood monocyte were estimated by ELISA. Results The PPAR- mRNA expression of peripheral blood monocyte and PDE onocyte on day 1 of EG （0. 52±0.06 and 0. 68±0. 07） respectively was significantly lower than that of CG （0.68±0.08 and 0.93±0.06） respectively that of EG and on day 5 （0.66±0.09 and 0. 89±0.08 respectively）. The TNF-a and IL-6 concentrations of peripheral blood monocyte on day 1 of EG [（20. 16 ± 11. 26）ng/L and （26. 89±13. 46）ng/L respectively] were significantly higher than that of CG [（6. 38±4. 28）ng/L and （8. 96 ±4. 67） ng/L respectively] and day 5 of EG [（5. 39 ± 3. 50）ng/L and （7. 83 ± 4. 26）ng/L respectively]. A significant negative correlation were observed between TNF- α and IL-6 concentration and PP γ mRNA expression. Conclusion The expression was significantly low at the initial stage of peritonitis in peritoneal dialysis patients. These data indicate that the PPAR γ might be involved in the defense mechanism of the Peritoneum.