Roles of Neutrophil Gelatinase-Associated Lipocalin in Continuous Ambulatory Peritoneal Dialysis-Related Peritonitis

• Published in: Journal of clinical immunology 2009-05, Vol.29 (3), p.365-378
• Main Authors: Leung, Joseph C. K, Lam, Man Fai, Tang, Sydney C. W, Chan, Loretta Y. Y, Tam, K. Y, Yip, Terence P. S, Lai, Kar Neng
• Format: Article
• Language: English
• Subjects: Acute-Phase Proteins - genetics; Acute-Phase Proteins - immunology; Acute-Phase Proteins - metabolism; Adult; Ambulatory Care; Biomarkers - metabolism; Biomedical and Life Sciences; Biomedicine; Cadherins - metabolism; Cell Movement; Cells, Cultured; Early Diagnosis; EMT; Gene Expression Regulation; Humans; IL-1β; Immunology; Infectious Diseases; Interleukin-1beta - metabolism; Internal Medicine; Kidney Failure, Chronic - complications; Kidney Failure, Chronic - therapy; Lipocalin-2; Lipocalins - genetics; Lipocalins - immunology; Lipocalins - metabolism; Male; Medical Microbiology; Middle Aged; neutrophils; Neutrophils - immunology; Neutrophils - metabolism; Neutrophils - pathology; NGAL; Peritoneal Dialysis - adverse effects; peritonitis; Peritonitis - diagnosis; Peritonitis - etiology; Peritonitis - metabolism; Peritonitis - pathology; Proto-Oncogene Proteins - genetics; Proto-Oncogene Proteins - immunology; Proto-Oncogene Proteins - metabolism; Snail Family Transcription Factors; Streptococcal Infections - etiology; Streptococcal Infections - immunology; Streptococcal Infections - metabolism; Streptococcus; TNF-α; Transcription Factors - metabolism; Transforming Growth Factor beta - metabolism; Vimentin - metabolism
• ISSN: 0271-9142; 1573-2592
• DOI: 10.1007/s10875-008-9271-7

Introduction We measured the neutrophil gelatinase-associated lipocalin (NGAL) concentration in peritoneal dialysate effluent (PDE) collected following an acute episode of continuous ambulatory peritoneal dialysis (CAPD)-related peritonitis. Results NGAL concentration in PDE increased in the first 3 days after developing peritonitis and correlated well with the neutrophil count. In patients with culture-negative peritonitis, the NGAL in PDE was lower than that in patients with gram-positive or gram-negative peritonitis. Apart from providing additional diagnostic support to bacterial-induced peritonitis, measurement of NGAL in PDE may be useful to differentiate the neutrophil-dependent culture-negative peritonitis from that associated with non-bacterial or non-cellular etiologies. Conclusion Human peritoneal mesothelial cell (HPMC) is another source of NGAL during peritonitis. NGAL was specifically induced in HPMC by IL-1β. Incubation of HPMC with recombinant NGAL reversed the transforming growth factor-β-induced up-regulation of Snail and vimentin but rescued the down-regulation of E-cadherin. Our data suggest that NGAL may exert a protective effect in modulating the epithelial-to-mesenchymal transition activated following peritonitis.