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Krediet RT. Dialysate Cancer Antigen 125 Concentration as Marker of Peritoneal Membrane Status in Patients Treated with Chronic Peritoneal Dialysis. Perit Dial Int 2020. [DOI: 10.1177/089686080102100605] [Citation(s) in RCA: 79] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
ObjectiveThis study reviews publications on the history of cancer antigen 125 (CA125), the background of its use as a marker of mesothelial cell mass, determination in peritoneal effluent, and its practical use in both the follow-up of peritoneal dialysis (PD) patients and as a marker of in vivo biocompatibility of dialysis solutions.DesignReview article.ResultsCA125 is a high molecular weight glycoprotein. Previous studies in ascites suggested its release by mesothelial cells. In vitro studies with cultured mesothelial cells showed constitutive production, the majority of which was dependent on mesothelial cell mass. Serum CA125 is normal in PD patients, but its concentration in peritoneal dialysate suggests local release, probably from mesothelial cells. Effluent CA125 can be considered a marker of mesothelial cell mass in stable PD patients, but large amounts are found during peritonitis, due probably to necrosis of mesothelial cells. The majority of studies found no relationship between dialysate CA125 and peritoneal transport parameters. Some cross-sectional studies reported a relationship with duration of PD, but others were unable to confirm this, due probably to the large interindividual variability. Longitudinal follow-up has shown a decrease in dialysate CA125, indicating loss of mesothelial cell mass. Application of theoretically morebiocompatible PD solutions causes an increase in dialysate CA125.ConclusionsDialysate CA125 is a mesothelial cell mass marker. The concentration of CA125 should be determined after a standardized dwell. A single low value is not informative. A decrease with time on PD suggests loss of mesothelial cell mass. Dialysate CA125 is a marker of in vivo biocompatibility of (new) dialysis solutions. More research is necessary on the best methodology for measuring low concentrations and establishing normal values and a significant change.
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Affiliation(s)
- Raymond T. Krediet
- Division of Nephrology, Department of Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
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Krediet RT, Zweers MM, Ho-Dac-Pannekeet MM, Van Der Wal AC, Smit W, Douma CE, Mateijsen MA, Struijk DG. The Effect of Various Dialysis Solutions on Peritoneal Membrane Viability. Perit Dial Int 2020. [DOI: 10.1177/089686089901902s43] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Raymond T. Krediet
- Division of Nephrology, Department of Medicine, University of Amsterdam, Dianet Foundation, Utrecht-Amsterdam, The Netherlands
| | - Machteld M. Zweers
- Division of Nephrology, Department of Medicine, University of Amsterdam, Dianet Foundation, Utrecht-Amsterdam, The Netherlands
| | - Marja M. Ho-Dac-Pannekeet
- Division of Nephrology, Department of Medicine, University of Amsterdam, Dianet Foundation, Utrecht-Amsterdam, The Netherlands
| | - Allard C. Van Der Wal
- Department of Cardiovascular Pathology, University of Amsterdam, Dianet Foundation, Utrecht-Amsterdam, The Netherlands
| | - Watske Smit
- Division of Nephrology, Department of Medicine, University of Amsterdam, Dianet Foundation, Utrecht-Amsterdam, The Netherlands
| | - Caroline E. Douma
- Division of Nephrology, Department of Medicine, University of Amsterdam, Dianet Foundation, Utrecht-Amsterdam, The Netherlands
| | - Maartje A.M. Mateijsen
- Division of Nephrology, Department of Medicine, University of Amsterdam, Dianet Foundation, Utrecht-Amsterdam, The Netherlands
| | - Dirk G. Struijk
- Division of Nephrology, Department of Medicine, University of Amsterdam, Dianet Foundation, Utrecht-Amsterdam, The Netherlands
- Academic Medical Center, University of Amsterdam, Dianet Foundation, Utrecht-Amsterdam, The Netherlands
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Al-Hwiesh AK, Shawarby MA, Abdul-Rahman IS, Al-Oudah N, Al-Dhofairy B, Divino-Filho JC, Abdelrahman A, Zakaria H, Nasr El-Din MA, Eldamati A, El-Salamony T, Al-Muhanna FA. Changes in peritoneal membrane with different peritoneal dialysis solutions: Is there a difference? Int J Organ Transplant Med 2016. [DOI: 10.1016/j.hkjn.2016.03.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Chaudhary K, Khanna R. Biocompatible Peritoneal Dialysis Solutions: Do We Have One?: Table 1. Clin J Am Soc Nephrol 2010; 5:723-32. [DOI: 10.2215/cjn.05720809] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Skotak M, Leonov AP, Larsen G, Noriega S, Subramanian A. Biocompatible and Biodegradable Ultrafine Fibrillar Scaffold Materials for Tissue Engineering by Facile Grafting of l-Lactide onto Chitosan. Biomacromolecules 2008; 9:1902-8. [DOI: 10.1021/bm800158c] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Maciej Skotak
- Department of Chemical and Biomolecular Engineering, University of Nebraska-Lincoln, Nebraska 68588-0643, and LNK Chemsolutions, LLC, 4701 Innovation Drive, Lincoln, Nebraska 68521
| | - Alexei P. Leonov
- Department of Chemical and Biomolecular Engineering, University of Nebraska-Lincoln, Nebraska 68588-0643, and LNK Chemsolutions, LLC, 4701 Innovation Drive, Lincoln, Nebraska 68521
| | - Gustavo Larsen
- Department of Chemical and Biomolecular Engineering, University of Nebraska-Lincoln, Nebraska 68588-0643, and LNK Chemsolutions, LLC, 4701 Innovation Drive, Lincoln, Nebraska 68521
| | - Sandra Noriega
- Department of Chemical and Biomolecular Engineering, University of Nebraska-Lincoln, Nebraska 68588-0643, and LNK Chemsolutions, LLC, 4701 Innovation Drive, Lincoln, Nebraska 68521
| | - Anuradha Subramanian
- Department of Chemical and Biomolecular Engineering, University of Nebraska-Lincoln, Nebraska 68588-0643, and LNK Chemsolutions, LLC, 4701 Innovation Drive, Lincoln, Nebraska 68521
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Gotloib L, Wajsbrot V, Shostak A. Icodextrin-induced lipid peroxidation disrupts the mesothelial cell cycle engine. Free Radic Biol Med 2003; 34:419-28. [PMID: 12566067 DOI: 10.1016/s0891-5849(02)01296-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Fluids commonly used for peritoneal dialysis hold poor biocompatibility vis a vis the peritoneal membrane, basically due to the presence of osmotic agents. When rat mesothelium was exposed to glucose-enriched dialysis solutions for 2 h in vivo, an early and short-lived acceleration of cell life cycle was observed, which, after 30 d of exposure, resulted in a depopulated monolayer of senescent cells. These changes appear to result from persistent oxidative stress due to continuous exposure to high concentration of glucose and to substances generated by the Maillard reaction. Long-term exposure (30 d) of the peritoneal mesothelium to 7.5% icodextrin resulted in a depopulated monolayer consisting mostly of senescent cells, which, additionally, showed atypical nuclear changes and atypical mitosis suggesting DNA damage. These changes coincided with substantial lipid peroxidation, starting immediately after the introduction of the icodextrin solution into the rat's abdominal cavity. So far, the currently used osmotic agents in peritoneal dialysis fluids induce substantial oxidative injury to the exposed monolayer in vivo. Use of high concentrations of glucose results in premature senescence of the exposed cell population. The 7.5% icodextrin dialysis fluid induces through lipid peroxidation substantial genomic damage, which, in turn, sets the biological mechanisms leading to protective cellular suicide in motion.
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Affiliation(s)
- Lazaro Gotloib
- Department of Nephrology and Hypertension and the Research Center for Experimental Nephrology, "Ha'Emek" Medical Center, Afula, Israel.
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Shostak A, Wajsbrot V, Gotloib L. High glucose accelerates the life cycle of the in vivo exposed mesothelium. Kidney Int 2000; 58:2044-52. [PMID: 11044224 DOI: 10.1111/j.1523-1755.2000.00376.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Mouse mesothelium exposed in vivo for 30 days to high glucose solutions develop morphological changes that characterize a population of cells near the end of their life span. METHODS The present study was designed to explore, in mesothelial cell imprints, whether these changes could derive from an early acceleration of the cell population life cycle in mice exposed for periods of up to 30 days to a 4.25% glucose fluid (236 mmol/L/L) prepared in Hank's balanced salt solution (HBSS). Three critical points of the cell's life cycle were evaluated: the G1 checkpoint [proliferating cell nuclear antigen (PCNA) expression], DNA synthesis ((3)H-thymidine incorporation), and the prevalence of mitosis. RESULTS Cell populations exposed to a high glucose concentration showed an initial acceleration of their life cycle, as sustained by a peak of mitosis at two hours, an early increase of DNA incorporation sustained during the first 24 hours, as well as a top level of PCNA expression after three to four hours. These significantly higher values, compared with the control animals treated with HBSS, collapsed after 24 hours and were nil after 30 days of exposure. CONCLUSIONS Exposure to a high glucose concentration induced an early and short-lived acceleration of the mesothelial cell cycle, and with a longer exposure this was followed by a depletion of the growth capabilities of the exposed monolayer.
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Affiliation(s)
- A Shostak
- Department of Nephrology and Hypertension, Ha'Emek Medical Center, Afula, Israel
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Abstract
The frequency, pathology, animal models, pathogenesis, clinical manifestations, diagnostic criteria, therapy and prevention of peritoneal sclerosis are reviewed. Many of these aspects have a bimodal configuration which suggests that peritoneal sclerosis, usually considered a single pathology in peritoneal dialysis, is actually two distinct nosological entities: simple sclerosis and sclerosing peritonitis. The former is very frequent, with minor anatomical alterations and low clinical impact; it is reproducible in animals by means of peritoneal dialysis, and is clearly due to the poor biocompatibility of peritoneal dialysis solutions. The latter is rare, with radical anatomical alterations and high mortality requiring valid methods of diagnosis, therapy and prevention; it can only be reproduced in animal models by means other than peritoneal dialysis and seems to be due to factors both related and unrelated to peritoneal dialysis.
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Affiliation(s)
- G Garosi
- Nephrology and Dialysis Department, Le Scotte Hospital, Siena, Italy.
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Gotloib L, Wajsbrot V, Shostak A, Kushnier R. Effect of hyperosmolality upon the mesothelial monolayer exposed in vivo and in situ to a mannitol-enriched dialysis solution. Nephron Clin Pract 2000; 81:301-9. [PMID: 10050085 DOI: 10.1159/000045297] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Studies done using the in vivo mouse model of population analysis of mesothelium showed that dialysis solutions containing high concentrations of glucose induced the development of a hypertrophic phenotype. Since these changes were neither related to the low pH nor to the presence of lactate buffer, we hypothesized that the presence of glucose was at the origin of the observed alterations. Theoretical analysis of the problem points to three possible mechanisms: hyperosmolality; metabolic changes derived from the high-glucose concentration itself, and/or the presence of products derived from the nonenzymatic degradation of glucose. The present study was designed to demonstrate or rule out the eventual effect of hyperosmolality upon the monolayer, applying the in vivo mouse model of population analysis of mesothelium. For this purpose, morphometric observations made in mice injected once a day during 30 consecutive days with a filter-sterilized 4.25% solution of mannitol (233.29 mM) were compared with those seen in intact mice and in a previously reported group of animals exposed to heat-sterilized fluid, having an equimolar concentration of glucose (235.9 mM), and the same osmolality (486 mosm/l) and electrolyte concentrations. The main findings observed in the mannitol-treated mice during the period of exposure included increased cell size and cytoplasmic surface area, as well as decreased cell viability. The regenerative capabilities of the exposed mesothelium remained intact. After a recovery period of 7 days, the aforementioned parameters reverted to normal values. This pattern is significantly different from the hypertrophic, senescent and low regenerative phenotype observed in mice treated with the high-glucose concentration solution. We conclude that, at least in the in vivo and in situ setup, the detrimental effects of hyperosmolality alone upon the exposed mesothelium are quite limited and fully reversible within a recovery period of 7 days.
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Affiliation(s)
- L Gotloib
- Department of Nephrology and Hypertension and Kornach Laboratory for Experimental Nephrology, 'Ha'Emek' Medical Center, Afula, Israel
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