title: Elastase, α1-proteinase inhibitor, and interleukin-8 in children and young adults with end-stage kidney disease undergoing continuous ambulatory peritoneal dialysis.
abstract: Peritoneal dialysis is one of the main modality of treatment in end-stage kidney diseases (ESKD) in children. In our previous work in chronic kidney disease patients, in pre-dialyzed period and on hemodialysis, the neutrophils were highly activated. The aim of this study was to assess an inflammatory condition and neutrophil activation in ESKD patients undergoing continuous ambulatory peritoneal dialysis (CAPD). Thirteen CAPD patients without infection, both sexes, aged 2.5-24 years, and group of healthy subjects (C) were studied. For comparative purposes the conservatively treated (CT) group of ESKD patients was included. Neutrophil elastase in complex with α1-proteinase inhibitor (NE-α1PI; ELISA), α1-proteinase inhibitor (α1PI; radial immunodiffusion) and interleukin-8 (IL-8; ELISA) were measured in the blood samples from CAPD, CT, and C group and in the peritoneal dialysate fluid (PDF) samples of patients on CAPD. A significantly increased plasma NE-α1PI levels (median 176.5 μg/L, range 85.2-373.2 μg/L; p < 0.00005), serum IL-8 (median 18.6 pg/mL, range 15.73-35.28 pg/mL; p < 0.05), and slightly decreased serum α1PI (median 1,540 mg/L, range 1,270-1,955; p ≤ 0.05) compared to the control groups were found. There were no significant differences of analyzed parameters between CAPD and CT patients. The concentration ratio of NE-α1PI, α1PI and IL-8 in blood/PDF was 29.97, 8.24, and 4.48, respectively. There were significantly positive correlations between serum and PDF concentration of α1PI and IL-8 (r = 0.613, p < 0.05; r = 0.59; p < 0.005, respectively). The results of our study demonstrate that neutrophils are highly activated in non-infected CAPD patients. The pivotal marker of this activation is NE-α1PI. It may contribute to chronic inflammation and tissues injury.
authors.affiliation: 3rd Department and Clinics of Pediatrics, Immunology and Rheumatology of Developmental Age, Medical University, Koszarowa 5, 51-149, Wroclaw, Poland, bozena.polanska@umed.wroc.pl.
authors.forename: Bożena
authors.initials: B
authors.lastname: Polańska
authors.forename: Daria
authors.initials: D
authors.lastname: Augustyniak
authors.forename: Irena
authors.initials: I
authors.lastname: Makulska
authors.forename: Maria
authors.initials: M
authors.lastname: Niemczuk
authors.forename: Adam
authors.initials: A
authors.lastname: Jankowski
authors.forename: Danuta
authors.initials: D
authors.lastname: Zwolińska
mesh_terms: D000293:Adolescent; D015550:Cell Degranulation; D002648:Child; D002675:Child, Preschool; D004791:Enzyme Inhibitors / Q000378:metabolism*; D005260:Female; D006801:Humans; D016209:Interleukin-8 / Q000378:metabolism*; D007676:Kidney Failure, Chronic / Q000175:diagnosis* / Q000276:immunology / Q000628:therapy; D019272:Leukocyte Elastase / Q000378:metabolism*; D008297:Male; D009504:Neutrophils / Q000276:immunology*; D010531:Peritoneal Dialysis, Continuous Ambulatory; D011485:Protein Binding; D055815:Young Adult
chemical_list: D004791:Enzyme Inhibitors; D016209:Interleukin-8; D019272:Leukocyte Elastase