氨基酸腹膜透析液与传统腹膜透析液对腹膜间皮细胞功能的影响

Different effects of amino acid based and glucose based dialysate from periotoneal dialysis patients on mesothelial cell function

目的通过体外实验对照观察了含氨基酸腹膜透析液(1.1%Nutrineal)和传统葡萄糖腹膜透析液(1.5%Dianeal)对正常人腹膜间皮细胞(HPMC)的生物相容性及功能的影响。方法用1.1%Nutrineal和1.5%Dianeal进行腹膜透析,4h后引流。观察两种不同透出液及不同时间对体外培养的HPMC功能的影响。采用四甲基偶氮多胍(MTT)和细胞直接计数法测定HPMC增殖程度,以测定乳酸脱氢酶(LDH)水平显示细胞损伤程度。采用ELISA法测定白细胞介素6(IL-6)水平。结果与5%葡萄糖对照组相比,1.5%Dianeal透出液可显著降低HPMC细胞增殖能力、细胞总蛋白合成、IL-6分泌水平和细胞黏附能力(P<0.001、P<0.001、P<0.0001、P<0.0001),而细胞培养液上清中的LDH分泌水平明显提高(P<0.001)。1.1%Nutrineal透出液可降低HPMC细胞增殖能力(P<0.001)和明显增加IL-6的分泌水平(P<0.0001),但对HPMC的LDH分泌水平,细胞黏附能力,蛋白总合成量无明显影响。结论与传统的葡萄糖腹膜透析液相比,氨基酸腹膜透析液能更好地维持HPMC在细胞存活能力、细胞黏附功能及蛋白合成等方面的功能。氨基酸腹膜透析液可诱导HPMC分泌IL-6水平显著升高,其机制有待进一步探讨。

Objective To investigate the effects of amino acid based and conventional peritoneal dialysis fluids(PDF),obtained from patients after a 4h dwell, on HPMC cell function. Methods 3 (4,5 dimethythiazol 2 yl) 2,5 diphenyl tetrazolium bromide (MTT) assay and cell counting were used to measure HPMC proliferation. The cells′viability was tested by lactate dehydrogenase (LDH) release. ELISA technique was used to measure interleukin 6 (IL 6) secretion. Results Exposure of HPMC to 1 5%Dianeal reduced cell proliferation, total cellular protein synthesis, IL 6 secretion and cell attachment, and increased LDH release(P< 0 001,P< 0 001,P< 0 0001,P< 0 0001, and P< 0 001 respectively). The 1 1%Nutrineal reduced HPMC proliferation (P< 0 001) and increased IL 6 secretion (P< 0 0001), but did not affect cell attachment, LDH release, protein synthesis or cell doubling time. Conclusions HPMC viability and protein synthesis are better preserved with amino acid based PDF, compared with conventional dextrose based PDF. The significance of IL 6 induction by Nutrineal remains to be elucidated.