Intraperitoneal interleukin-8 and neutrophil influx in the initial phase of a CAPD peritonitis.
OBJECTIVE
To investigate whether or not a change in dialysate interleukin-8 (IL-8) concentration precedes the onset of clinically overt peritonitis and is significant in the recruitment of granulocytes during continuous ambulatory peritoneal dialysis (CAPD)-related peritonitis.


METHODS
CAPD patients stored their overnight effluent at 4 degrees C, which was routinely thrown away after 2 days. If peritonitis developed, patients delivered their effluent of the preceding two nights and the peritonitis effluent for analysis. A control study was performed 1 to 3 months after recovery. Dialysate samples were analyzed for number of cells, differential cell count, IL-8 and elastase concentrations, and their neutrophil chemoattractive capacity. In addition, serum samples during peritonitis were analyzed for IL-8 concentrations.


RESULTS
Ten peritonitis episodes in 7 patients were analyzed. Numbers of neutrophils and levels of dialysate IL-8 and elastase started to increase 4 to 12 hours before the first peritonitis effluent. The dialysate/serum IL-8 ratio was 423.5 during peritonitis and 7.0 in the postperitonitis controls. There was a significant correlation between the number of neutrophils and IL-8 concentration in the dialysate. The in vitro neutrophil chemotaxis was increased toward the peritonitis effluents, as compared to control effluents. Incubation of the peritonitis effluents with anti-IL-8 monoclonal antibody blocked the increase in neutrophil chemotaxis above control levels by an average of 26.7%.


CONCLUSIONS
IL-8 is produced in the peritoneal cavity during CAPD treatment and may mediate part of the neutrophil recruitment and degranulation in the initial phase of a CAPD peritonitis.
Betjes
M G
MG
Department of Cell Biology, Vrije Universiteit, Amsterdam, The Netherlands.
Visser
C E
CE
Zemel
D
D
Tuk
C W
CW
Struijk
D G
DG
Krediet
R T
RT
Arisz
L
L
Beelen
R H
RH
D000328:Adult; D002465:Cell Movement; D002634:Chemotaxis, Leukocyte; D015314:Dialysis Solutions / Q000737:chemistry; D005260:Female; D006098:Granulocytes / Q000502:physiology; D006801:Humans; D016209:Interleukin-8 / Q000378:metabolism*; D007958:Leukocyte Count; D019272:Leukocyte Elastase / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000502:physiology*; D010529:Peritoneal Cavity / Q000473:pathology*; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000009:adverse effects*; D010538:Peritonitis / Q000209:etiology / Q000473:pathology / Q000503:physiopathology*
D015314:Dialysis Solutions; D016209:Interleukin-8; D019272:Leukocyte Elastase