Читать книгу Recent Advances in Dialysis Therapy in Japan - Группа авторов - Страница 14

We have evaluated the level of fibrosis under different pH of PD solution. The result indicated that the stronger the acidity of PD solution, the stronger the fibrotic response. In addition, there was a correlation between peritoneal fibrosis and eosinophilic infiltration of peritonitis tissues [10] (Fig. 1). Cells exposed to stress or damaged cells are known to initiate immune reactions [21]. Damaged tissues and cells release uric acid [22], which is considered to provoke some kind of immune reaction in the body [23]. This indicates that eosinophils may be involved in the reaction. Therefore, we point out that the role of eosinophils can involve not only inflammatory allergic reactions but that migration of eosinophils, which is caused by the danger signal, a substance released when body tissues are damaged by nonspecific stimulation, can trigger immune reactions and evoke effector functions [13, 14]. This can justify, for example, a report on eosinophilic peritonitis as a factor for the development of EPS associated with icodextrin, which is widely used in Japan [24], and another report on the possibility that the acidity of PD solution (pH: 5.0) can damage peritoneal cells [25]. The pathogenesis of these complexes is still unclear in many aspects. Therefore, if eosinophils are associated with the mechanism of peritonitis and/or pathogenesis of fibrosis, existing treatments for eosinophilic inflammation may be used as new countermeasures or treatments.