Abstract
Glucose-based solutions remain the most used osmotic agents in peritoneal dialysis (PD), but unavoidably they contribute to the loss of peritoneal filtration capacity. Here, we evaluated at a molecular level the effects of XyloCore, a new PD solution with a low glucose content, in mesothelial and endothelial cells. Cell viability, integrity of mesothelial and endothelial cell membrane, activation of mesothelial and endothelial to mesenchymal transition programs, inflammation, and angiogenesis were evaluated by several techniques. Results showed that XyloCore preserves mesothelial and endothelial cell viability and membrane integrity. Moreover XyloCore, unlike glucose-based solutions, does not exert pro-fibrotic, -inflammatory, and -angiogenic effects. Overall, the in vitro evidence suggests that XyloCore could represent a potential biocompatible solution promising better outcomes in clinical practice.
Highlights
Peritoneal dialysis (PD) is one of the therapeutic options available for end-stage renal disease (ESRD) patients and represents an important alternative to hemodialysis (HD) [1].PD offers more flexibility, allowing patients to continue working; it preserves their residual renal function and has a lower cardiovascular impact than HD [2,3,4].On the other hand, continuous contact with glucose dialysis solutions during PD can induce significant morphological and functional changes in the peritoneum [5]
Once stable resistances had been obtained, different solutions were tested for 3 h, and cells were recovered in complete medium
HMRSV5 mesothelial and HUVEC mesothelial cells seeded on plastic showed a viability modulation when exposed for three hours to glucose-based PD solution
Summary
Continuous contact with glucose dialysis solutions during PD can induce significant morphological and functional changes in the peritoneum [5]. These include progressive sub-mesothelial thickening, narrowing and distortion of the vascular lumen with hyalinization, thickening of the basal capillary membrane, as well as thickening of the arterial wall, greater synthesis of pro-inflammatory cytokines and reactive oxygen species, inhibition of cell growth and proliferation, and DNA damage [6,7,8,9,10,11]. Long-term exposure to PD fluids can cause morphological and functional changes similar to those that occur during epithelial-mesenchymal transition (EMT) [16,17,18], and induce mesothelial to mesenchymal transition (MMT) [19]
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