特集名 | CAPD療法の新たな展開 | |
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題名 | 腹膜劣化防止および再生医学 (1) ブドウ糖毒性とGDPs対策 | |
発刊年月 | 2004年 10月 | |
著者 | 友 雅司 | 大分大学医学部感染分子病態制御講座 |
【 要旨 】 | 腹膜透析液におけるglucose degradation products (GDPs) は腹膜組織への傷害の原因の一つである.新しく発見されたGDPsである3,4-di-deoxyglucosone-3-ene (3,4-DGE) は,酸性腹膜透析液中に含まれる濃度でヒト腹膜中皮細胞の細胞活性を有意に低下させ,酸性透析液におけるGDPsの毒性の多くは,この3,4-DGEに起因すると考えられる.したがって,3,4-DGEの透析液中濃度を低減化すること,また3,4-DGEの毒性を軽減すべく,他の透析液の因子を改善すべきである. two chambered bag,中性液では3,4-DGE濃度は酸性液と比較して1/10以下になっており,細胞毒性も減少した. 加えて,この3,4-DGEの毒性を軽減させるためには透析液のpHの上昇,bufferとしてのlactateの減少化が望まれる. |
Theme | New Development in CAPD Therapy | |
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Title | Cytotoxicity of GDPs on HPMC, and strategies for reduction | |
Author | Tadashi Tomo | Second Department of Internal Medicine, Faculty of Medicine, Oita University |
[ Summary ] | Glucose degradation products (GDPs) in peritoneal dialysis fluid (PDF) comprise one of the risk factors in the deterioration of peritoneal functioning. The newly developed GDPs, 3,4-di-deoxyglucoson-3-ene (3,4-DGE) decreased the viability of human peritoneal mesothelial cells (HPMC) significantly with concentrations of acidic pH PDF. It is thought that the cytotoxicity of GDPs in acidic pH PDF results from 3,4-DGE. Hence, measures to decrease concentrations of 3,4-DGE in PDF and changing other factors related to PDF to decrease the cytotoxicity of 3,4-DGE must be carried out. Compared to acidic pH PDF, the concentration of 3,4-DGE was significantly lower (about one tenth) in neutral pH cases, with two chambered bag PDF. Cytotoxicity was also lowered with neutral pH, two chambered bag PDF. Additionally, to rise the pH in PDF and decrease levels of lactate used as a buffer in PDF it is hoped we may decrease the cytotoxicity of 3,4-DGE in PDF. |