CD147 expression in peritoneal injury
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Peritoneal injury is an important cause of technical failure of long-term peritoneal dialysis (PD). Encapsulating peritoneal sclerosis (EPS) is a severe complication of long-term PD with potentially life threatening consequences. CD147 is a glycoprotein with diverse functions including modulation of extracellular matrix via induction of matrix metalloproteinases, cell adhesion, and regulation of immune reactions. We hypothesized that CD 147 plays a role in the peritoneal cavity.
In this retrospective study, we localized CD147 by immunohistochemistry in peritoneal biopsies from uremic patients not on PD (n = 8), on PD without signs of EPS (n = 7), and in biopsies in patients with the diagnosis of EPS (n = 7). Double immunofluorescence was used to co-localize α-smooth-muscle actin (α-SMA) and CD147 in selected biopsies from each group. Expression was scored semi-quantitatively.
In biopsies from uremic controls, CD147 was prominently expressed in mesothelial cells, focally between fat cells and by some perivascular cells. In patients on PD, a similar distribution was present (although mesothelium was rarely conserved), with some focal accentuation. In EPS, layers of fibroblastic cells were positive for CD147. EPS biopsies demonstrated a significantly higher score in a blinded evaluation, compared to uremic patients. Cells expressing CD147 were α-SMA positive myofibroblasts as demonstrated by double immunofluorescence. Mean CD147 scores did not differ between patients with different transporter status.
This is the first study demonstrating CD147 on a major part of fibroblastic cells in EPS. Future studies need to address the role of these cells in this severe complication of long-term PD.
KeywordsPeritoneal dialysis Encapsulating peritoneal sclerosis EPS Emmprin CD147
St. S. is supported by a Grant by Fundação Pesquisa e Desenvolvimento Humanitario; and the Else-Kröner Fresenius Stiftung. J.L. and D.K. by the Robert-Bosch Foundation.
Compliance with ethical standards
Conflict of interest
Stephan Segerer receives benefits from Peripal and Baxter as a consultant.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee at which the studies were conducted (#322/2009BO1, Ethic committee, Eberhard-Karls University Tuebingen, Germany) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
All patients had given their written informed consent concerning a scientific work-up of tissues taken during surgery.
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