丙酮酸盐腹透液保护中性粒细胞一氧化氮的生成

Pyruvate preserves nitric oxyde producted by human neutrophils in peritoneal dialysis solution

目的 研究以丙酮酸盐替代乳酸盐作缓冲碱的酸性高糖腹透液 (PDS)对人外周血中性粒细胞(PMN)功能的影响 ,探讨丙酮酸盐腹透液 (P PDS)优良生物相容性的作用机制。方法 将PDS的缓冲碱分为乳酸盐和丙酮酸盐 2种 ,分别配制成酸碱度 (pH)为 5 .2和7.4及葡萄糖浓度为 1.5 %和 4.2 5 %等 8种 ,并以Han ks’平衡盐溶液 (HBSS ,pH 7.4)为对照 ,采用紫外分光法 ,分别测定各种不同 pH、不同葡萄糖浓度和不同缓冲碱的PDS对PMN产生一氧化氮 (NO)功能的影响。结果 酸性和高糖对PMN产生NO的功能有明显的抑制 ;而且葡萄糖浓度愈高对PMN功能的抑制愈明显。但是在相同葡萄糖浓度 ,不论 pH为 5 .2或 7.4,P PDS均较乳酸盐腹透液 (L PDS)显著改善PMN产生NO的功能。同时 pH 7.4的P PDS较HBSS明显减轻高糖抑制PMN产生NO的功能。结论 丙酮酸盐作缓冲碱能显著减轻非生理性PDS对细胞的毒性作用 ,保护细胞的功能 ,提高PDS的生物相容性。

Objective To investigate the effects of pyruvate on human peripheral blood polymorphonuclear neutrophils (PMN) in acidic, high glacoseenriched peritoneal dialysis solutions (PDS) and to explore the potential mechanism of the cytotoxicity of unphysiological PDS neutralized by pyruvate based peritoneal dialysis solutions(P PDS). Methods Eight sorts of PDS containing lactate or pyruvate and having an original pH value of 5.2 or 7.4 and composed of 1.5% or 4.25% glucose were prepared. Further, the preparations of Hanks' balanced salt solution(HBSS)containing 0.1%, 1.5% and 4.25% glucose at pH 7.4 were made as controls. Nitric oxide(NO) production by PMN stimulated with opsonized zymosan for 20 minutes after exposure to various PDS and HBSS were determined based on Griess reaction. Results NO generation by PMN exposed to high glucose or acidic PDS was severely inhibited and the higher glucose concentration, the less NO generation. However, P PDS significantly improved NO formation when compared with lactate based peritoneal dialysis solutions(L PDS)at the corresponding levels of glucose and pH . In addition, NO production by PMN after exposure to P PDS were evidently higher than that of HBSS at high glucose level . Conclusion Pyruvate may neutralize the cytotoxicity of unphysiological PDS on cells and protect the function of cells and greatly improve the biocompatibility of PDS.