Abstract

Intraperitoneal inflammation is the most important determinant of peritoneal fibrosis in patients with long-term peritoneal dialysis (PD). Spliced x-box binding protein-1 (XBP1s), a major proximal effector of unfolded protein response (UPR) signaling, plays an indispensable role in inflammation. Our study demonstrated that the inflammatory factor interleukin-1β (IL-1β) dose- and time-dependently induced XBP1s upregulation and interleukin-6 (IL-6) secretion, as well as the expression of the fibrotic marker fibronectin. However, these effects were prevented by the IRE1 endonuclease inhibitor STF083010 since it time-dependently reduced IL-1β-induced Xbp1 mRNA splicing, XBP1s protein expression, inflammatory factor IL-6 secretion and the expression of the fibrotic marker fibronectin in human peritoneal mesothelial cells (HPMCs). The overexpression and knockdown of XBP1s in HPMCs had a similar effect on fibronectin expression. In a rat model of peritoneal inflammation, STF083010 significantly attenuated chlorhexidine digluconate-induced XBP1s and α-smooth muscle actin expression, as well as fibrotic tissue proliferation, in the peritoneum. Our results suggest that XBP1s is a strong pathogenic factor that mediates inflammation-induced peritoneal fibrosis in peritoneal dialysis.

Highlights

  • Intraperitoneal inflammation is the most important determinant of peritoneal fibrosis in patients with long-term peritoneal dialysis (PD)

  • To mimic inflammation in peritoneal dialysis, we treated human peritoneal mesothelial cells (HPMCs) with the inflammatory factor IL-1β to identify whether XBP1s is involved in this inflammatory process

  • IL-1β significantly induced XBP1s protein expression (Fig. 1C) in HPMCs. These results suggest that XBP1s is likely involved in the inflammatory process in HPMCs in peritoneal dialysis

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Summary

Introduction

Intraperitoneal inflammation is the most important determinant of peritoneal fibrosis in patients with long-term peritoneal dialysis (PD). Several factors contribute to peritoneal inflammation during long-term PD These factors include (1) the inflammatory status of chronic kidney disease as a result of a reduction in the renal clearance of cytokines, fluid overload, immunological dysfunction and infectious comorbidity[4], (2) long-term exposure of the peritoneal membrane to unphysiological dialytic solutions with high glucose and low pH5, (3) PD-related peritonitis[6], (4) uremia-induced inflammation in the peritoneum[7], and (5) protein energy wasting[8]. These factors are usually related to one other and eventually lead to peritoneal fibrosis. Gene XBP1s Sense Antisense IL-6 Sense Antisense IL-8 Sense Antisense TNFα Sense Antisense 18S RNA Sense Antisense

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