Abstract

Abstract Background and Aims Peritoneal dialysis (PD) is an effective method of renal replacement therapy (RRT). The long-term use of PD as RRT is limited due to adverse effects of high glucose-based PD fluids (PDFs) to the structure and function of the peritoneal membrane. Our group recently elucidated one pathological mechanism showing that glucose-based PDFs enhance oxidative DNA-damage in PD patients due to reduced thioredoxin (TRX) activity trigged by thioredoxin-interacting-protein (TXNIP) upregulation (Oberacker et al., 2022). Therefore, the aim of this in vitro study was to investigate drug treatments to mitigate oxidative stress and oxidative DNA-damage due to glucose-dependent induction of TXNIP expression. Method Using a mesotheliomal cell line (NCl-H28, ATCC) we performed in vitro studies mitigating reactive oxygen species (ROS) production and oxidative DNA damage as well. Cells were treated for three and eight hours with high-glucose media (1.5%, 2.3% and 4.25% glucose; glucose concentrations were adapted to PDFs from Fresenius Medical Care) compared to control media (normal glucose concentration). mRNA expression of TXNIP, TRX and further redox-related genes like superoxide dismutases (SODs) or catalase were analyzed by qPCR. Since TRX is negatively regulated by TXNIP, we investigated TRX activity in cell lysates. ROS production was monitored using a bioluminescent assay and immunofluorescence using the redox dye CellRoxGreen as well. The content of oxidative DNA-damage was investigated by immunofluorescence. Furthermore, we have preliminary analysis using primary human peritoneal mesothelial cells derived from PD effluent (PDF). Results We demonstrated a dose-dependent upregulation of round 1.5 fold TXNIP expression on mRNA level. However, no change in the expression of TRX, SODs and catalase could be observed. Interestingly, we observed a 20% reduction in TRX activity upon glucose stimulation compared to cells treated with control media. These findings are consistent with the previously published data on human peritoneal biopsies. Beyond, we demonstrated a dose-dependent increase in ROS production and increase in oxidative DNA-damage. However, ROS production and oxidative DNA damage could be prevented upon pre-incubation with the ROS-scavenger N-acetylcysteine (NAC). Conclusion Here, we show that enhanced levels of ROS and oxidative DNA damage due to glucose induced TXNIP expression could be diminished using ROS scavengers. These findings show that further antioxidative substances may be potential drugs, which could also be potential drug candidates for use in clinical practice to treat PD patients.

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