Peritoneal fibrosis and the putative role of decorin

SummaryInduction of epithelial-to-mesenchymal transition (EMT) in mesothelial cells during peritoneal dialysis (PD) and peritonitis is an orchestrated process characterized by the loss of cell–cell contact, reorganization of the actin cytoskeleton, basement membrane degradation, and acquisition of a migratory and invasive phenotype. EMT contributes to peritoneal fibrosis, which can lead to the failure of PD as a treatment modality for patients with end-stage renal disease. Decorin is a dermatan sulfate proteoglycan that possesses antifibrotic properties and has been shown to suppress tissue fibrosis. This review will discuss changes observed in the mesothelium during PD, induction of EMT and peritoneal fibrosis, and the potential beneficial effect of decorin in the intervention of peritoneal fibrosis.

摘要腹膜透析本身和腹膜炎均可導致腹膜組織中間皮細胞發生上皮-間葉轉化（epithelial-to-mesenchymal transition，EMT），這個過程表現為細胞間連接受損、骨架重排以及基底膜降解，進而細胞呈現遊走性和侵襲性等特徵。間皮細胞EMT可引發腹膜纖維化，後者是腹膜透析患者技術失敗的常見原因。核心蛋白多醣（decorin）是一種硫酸皮膚素類蛋白多醣，既往研究提示其有抗纖維化作用。本綜述將闡述腹膜透析過程中間皮細胞EMT以及腹膜纖維化的形態特徵及發生機制，並討論核心蛋白多醣在緩解腹膜纖維化中的可能作用。