Epithelial to Mesenchymal Transition of Mesothelial Cells as a Mechanism Responsible for Peritoneal Membrane Failure in Peritoneal Dialysis Patients

  • Abelardo Aguilera
  • Luiz S. Aroeira
  • Marta Ramírez-Huesca
  • José A. Jiménez-Heffernan
  • Rafael Selgas
  • Manuel López-Cabrera
Chapter
Part of the Biotechnology Intelligence Unit book series (BIOIU)

Abstract

Peritoneal dialysis (PD) is an alternative to hemodialysis for the treatment of end-stage renal disease and is based on the use of the peritoneum as a semi-permeable membrane for water and solutes. Peritoneal membrane fibrosis (or sclerosis) is one of the most frequent complications of PD that includes a wide spectrum of peritoneal structural changes, ranging from mild inflammation to severe sclerosing peritonitis and encapsulating-sclerosing peritonitis. In parallel with fibrosis, the peritoneum shows a progressive increase of capillary number (angiogenesis) and vasculopathy, which are involved in increased small solute transport across the peritoneal membrane and ultrafiltration failure. Local production of vascular endothelial growth factor (VEGF) during PD appears to play a central role in the processes leading to peritoneal angiogenesis and functional decline. The most important factors of the PD solutions responsible of peritoneal deterioration are glucose and glucose degradation products, which stimulate transforming growth factor-β (TGF-β) and VEGF production by mesothelial cells (MC). TGF-β is a potent pro-fibrotic factor and inducer of epithelial-mesenchymal transition (EMT) of the MC.

This review discusses the mechanism implicated in peritoneal structural alteration and points to EMT of MC as protagonist and starter of peritoneal membrane injury through the increase of submesothelial fibroblast population. Possible mechanisms of regulation and new targets for inhibition of EMT or its deleterious effects are proposed.

Keywords

Vascular Endothelial Growth Factor Peritoneal Dialysis Connective Tissue Growth Factor Mesothelial Cell Peritoneal Dialysis Patient 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
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Copyright information

© Landes Bioscience and Springer Science+Business Media 2006

Authors and Affiliations

  • Abelardo Aguilera
    • 1
  • Luiz S. Aroeira
    • 1
  • Marta Ramírez-Huesca
    • 1
  • José A. Jiménez-Heffernan
    • 2
  • Rafael Selgas
    • 3
  • Manuel López-Cabrera
    • 4
  1. 1.Unidad de Biología Molecular Instituto Reina Sofía de Investigaciones NefrológicasHospital Universitario de la PrincesaMadridSpain
  2. 2.Departamento de Patología Instituto Reina Sofía de Investigaciones NefrológicasHospital Universitario de GuadalajaraGuadalajaraSpain
  3. 3.Servicio de Nefrología Instituto Reina Sofía de Investigaciones NefrológicasHospital Universitario La PazMadridSpain
  4. 4.Unidad de Biología MolecularHospital Universitario de la PrincesaMadridSpain

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