| Objective:To use the Luminex FlexMap3D system to detect the cytokine profiles in peritoneal dialysis effluent(PDE) of stable continuous ambulatory peritoneal dialysis(CAPD) patients,including inflammatory cytokines, angiogenic factor and pro-EMT/fibrosis factor;To investigate the relationship between PSTR and dialysate cytokine profiles or systemic micro-inflammatory makers in PDE;To analysis the relationship among cytokine profiles.Methods:Thirty CAPD patients were admitted. Clinical parameters such as age, sex, comorbid disease, body mass index and renal function were noted. Serum albumin, high sensitivity C-reactive protein(hs-CRP) were also assessed. Overnight PDE were collected, standard peritoneal equilibration test(PET)was performed to evaluate PSTR by calculating dialysate/plasma creatinine (D/P Cr). Using the Luminex FlexMap3D system to examine the level of cytokine profiles:inflammatory cytokine (IL-6, MCP-1, TNFa, IL-17A, IL-17F, IL-21, IL-22, IL-23), angiogenic factor (VEGF), pro-EMT/fibrosis factor (TGF-β1).Results:For inflammatory cytokines, the dialysate concentrations of IL-6,MCP-1and TNFa were66.4±59.8pg/ml,221±96.1pg/ml,1.79±0.34pg/ml. Dialysate IL-17A, IL-17F, IL-21, IL-22, IL-23could not be detected. The level of VEGF was19.3±26.6pg/ml,and TGF-β1was3312±1133pg/ml. According to the peritoneal transport characteristics, all patients were divided into low and low-average transport (L/A)(D/P Cr<0.64) group, high and high average transport (H/A)(D/P Cr≥0.65) group, respectively. Dialysate IL-6in H/A group were higher than L/A group(P<0.05), but MCP-1, TNF-a, TGF-β1, VEGF level were not statistically significant between two groups (P>0.05).Among PDE inflammatory profiles, IL-6levels (r=0.656, P<0.001), MCP-1level (r=0.620, P<0.001) was significantly associated with D/P Cr;Dialysate VEGF(r=0.425, P=0.019) and TGF-betal(r=0.425, P=0.019) were also positively correlated with D/P Cr. Among systemic markers, serum albumin and D/P Cr showed a negative correlation (r=-0.369, P=0.045). Multivariate analysis showed that D/P Cr is independently correlated with dialysate IL-6. Besides, dialysate IL-6, MCP-1, VEGF and TGF-betal correlated with each other:IL-6vs MCP-1(r=0.655, P<0.001), IL-6vs VEGF(r=0.421, P=0.023), IL-6vs TGF-betal (r=0.577, P=0.001), MCP-1vs VEGF (r-0.639, P<0.001), MCP-1vs TGF-betal (r=0.543, P=0.002), VEGF vs TGF-betal(r=0.631, P<0.001). TNF-a didn’t correlated with any other cytokines. TGF-betal negtively correlated with eGFR(r=-0.370, P=0.048), and for these patients whose eGFR>2ml/min/1.73m2, its TGF-betal level is much lower than the rest (P=0.018).Serum albumin negtively associated with dialyslate TGF-betal (r=-0.449,P=0.014),whereas hs-CRP showed no significant differences with dialyslate markers.Conclusion:The results showed that (1)The Luminex system is able to detect the cytokine profiles in PDE in stable CAPD patients, implying an existence of chronic peritoneal inflammation, neovascularization, EMT or fibrosis in peritoneal cavity;(2) The cytokine associated with chronic peritoneal inflammation, neovascularization, EMT and peritoneal fibrosis were correlated with each other,and working together for PSTR increasing,andD/P Cr could be independantly predicted by dialysate IL-6.(3) The increase of Th17related cytokines were not yet detected in stable CAPD patients.(4) PDE TGF-betal level was corrleted with eGFR.(5)The relationship between systemic micro-inflammatory makers and PSTR was still obscure. |
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