Abatacept as a therapeutic option in the treatment of encapsulated peritoneal sclerosis: an experimental rat model.

Abstract

Encapsulated peritoneal sclerosis (EPS) is a rare complication of long-term peritoneal dialysis (PD) and is usually associated with mortality. Inflammation is a leading factor for developing EPS. This study aimed to investigate the effect of abatacept on peritoneal fibrosis and inflammation using the EPS rat model. Twenty-four Wistar albino rats were randomly divided into four equal groups. Group I (control group) was administered isotonic saline (IS) via the intraperitoneal (ip) route during weeks 0-3. Chlorhexidine gluconate (CG) ip was administered to group II (CG group) during weeks 0-3. Group III (CG+IS group) received CG for the first 21days and IS solution for the following 3weeks. Group IV (abatacept group) received CG during weeks 0-3, and subsequently, 50mcg/day abatacept during weeks 4-6. Peritoneal thickness, fibrosis, and inflammation were examined using light microscopy. Expressions of matrix metalloproteinase-2 (MMP-2) and transforming growth factor-beta 1 (TGF-β1) were detected by immunohistochemical staining. Lesser peritoneal thickness and lower inflammation score were observed in the abatacept group than in the CG and CG+IS groups (p<0.05). Furthermore, the abatacept group had a lower fibrosis score than the CG+IS group (p<0.05). MMP-2 and TGF-β1 scores were lower in the abatacept group than in the CG+IS group (p<0.05). The results revealed that abatacept had a histopathological beneficial effect on peritoneal fibrosis, inflammation, MMP-2, and TGF-β1 scores, which were induced by CG. Abatacept could be a new therapeutic option for treating EPS.