Document Detail


Can effluent matrix metalloproteinase 2 and plasminogen activator inhibitor 1 be used as biomarkers of peritoneal membrane alterations in peritoneal dialysis patients?
MedLine Citation:
PMID:  23994841     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Peritoneal effluent contains clinically relevant substances derived from intraperitoneal production or transperitoneal transport, or both. The glycoproteinase matrix metalloproteinase 2 (MMP-2) cleaves denatured collagen and complements other collagenases in the degradation of fibrillar collagens. Elevated intraperitoneal levels of plasminogen activator inhibitor 1 (PAI-1) have been demonstrated to be present in patients with intra-abdominal adhesions. The aim of the present study was therefore to investigate the potential for effluent MMP-2 and PAI-1 to be used as markers of the development of peritoneal alterations. In addition, MMP-2 was analyzed in previously frozen effluent samples from a uremic rat model, in which data concerning the severity of peritoneal fibrosis were available.
METHODS: This prospective, single-center cohort study included 86 incident peritoneal dialysis (PD) patients. All patients were treated solely with biocompatible dialysis solutions and underwent a standard peritoneal permeability analysis (SPA). The presence of local MMP-2 and PAI-1 production and the relationships between those markers and peritoneal transport parameters were analyzed. Furthermore, effluent interleukin 6 was analyzed as a marker of local inflammation.
RESULTS: Median effluent levels of 21.4 ng/mL for MMP-2 and 0.9 ng/mL for PAI-1 were found. The median dialysate appearance rates were 218.8 ng/min for MMP-2 and 9.6 ng/min for PAI-1. Local peritoneal production averaged 90% of effluent MMP-2 concentration and 74% of effluent PAI-1 concentration. Furthermore, correlations between peritoneal transport parameters and MMP-2 and PAI-1 were observed. Longitudinal follow-up showed no change for MMP-2 (p = 0.37), but a tendency for PAI-1 to increase with the duration of PD (p < 0.001). In rats, a significant relationship was present between the extent of peritoneal fibrosis and the appearance rate of MMP-2 (r = 0.64, p = 0.03).
CONCLUSIONS: The foregoing data illustrate the potential of effluent MMP-2 and PAI-1 as biomarkers of peritoneal modifications, especially fibrosis; however, the components of peritoneal transport and local production should be clearly distinguished in every patient.
Authors:
Deirisa Lopes Barreto; Annemieke M Coester; Dirk G Struijk; Raymond T Krediet
Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2013-09-01
Journal Detail:
Title:  Peritoneal dialysis international : journal of the International Society for Peritoneal Dialysis     Volume:  33     ISSN:  1718-4304     ISO Abbreviation:  Perit Dial Int     Publication Date:    2013 Sep-Oct
Date Detail:
Created Date:  2013-10-17     Completed Date:  2014-07-10     Revised Date:  2014-09-02    
Medline Journal Info:
Nlm Unique ID:  8904033     Medline TA:  Perit Dial Int     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  529-37     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Animals
Biological Markers / metabolism
Female
Follow-Up Studies
Humans
Kidney Failure, Chronic / metabolism,  therapy*
Male
Matrix Metalloproteinase 2 / biosynthesis*
Middle Aged
Peritoneal Dialysis / adverse effects*
Peritoneal Fibrosis / enzymology*,  etiology
Peritoneum / metabolism*
Permeability
Plasminogen Activator Inhibitor 1 / biosynthesis*
Prospective Studies
Rats
Young Adult
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Plasminogen Activator Inhibitor 1; EC 3.4.24.24/Matrix Metalloproteinase 2
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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