title: Shorter daily dwelling time in peritoneal dialysis attenuates the epithelial-to-mesenchymal transition of mesothelial cells.
abstract: BACKGROUND
  Peritoneal dialysis (PD) therapy is known to induce morphological and functional changes in the peritoneal membrane. Long-term exposure to conventional bio-incompatible dialysate and peritonitis is the main etiology of inflammation. Consequently, the peritoneal membrane undergoes structural changes, including angiogenesis, fibrosis, and hyalinizing vasculopathy, which ultimately results in technique failure. The epithelial-to-mesenchymal transition (EMT) of mesothelial cells (MCs) plays an important role during the above process; however, the clinical parameters associated with the EMT process of MCs remain to be explored.
  
  
  METHODS
  To investigate the parameters impacting EMT during PD therapy, 53 clinical stable PD patients were enrolled. EMT assessments were conducted through human peritoneal MCs cultured from dialysate effluent with one consistent standard criterion (MC morphology and the expression of an epithelial marker, cytokeratin 18). The factors potentially associated with EMT were analyzed using logistic regression analysis. Primary MCs derived from the omentum were isolated for the in vitro study.
  
  
  RESULTS
  Forty-seven percent of the patients presented with EMT, 28% with non-EMT, and 15% with a mixed presentation. Logistic regression analysis showed that patients who received persistent PD therapy (dwelling time of 24 h/day) had significantly higher EMT tendency. These results were consistent in vitro.
  
  
  CONCLUSIONS
  Dwelling time had a significant effect on the occurrence of EMT on MCs.
authors.forename: Yi-Che
authors.initials: YC
authors.lastname: Lee
authors.forename: Yau-Sheng
authors.initials: YS
authors.lastname: Tsai
authors.forename: Shih-Yuan
authors.initials: SY
authors.lastname: Hung
authors.forename: Tsun-Mei
authors.initials: TM
authors.lastname: Lin
authors.forename: Sheng-Hsiang
authors.initials: SH
authors.lastname: Lin
authors.forename: Hung-Hsiang
authors.initials: HH
authors.lastname: Liou
authors.forename: Hsiang-Chun
authors.initials: HC
authors.lastname: Liu
authors.forename: Min-Yu
authors.initials: MY
authors.lastname: Chang
authors.forename: Hsi-Hao
authors.initials: HH
authors.lastname: Wang
authors.forename: Li-Chun
authors.initials: LC
authors.lastname: Ho
authors.forename: Yi-Ting
authors.initials: YT
authors.lastname: Chen
authors.forename: Hsin-Pao
authors.initials: HP
authors.lastname: Chen
authors.forename: Hong-Arh
authors.initials: HA
authors.lastname: Fan
authors.forename: Kuang-Wen
authors.initials: KW
authors.lastname: Liu
authors.forename: Yung-Tang
authors.initials: YT
authors.lastname: Kung
authors.forename: Hao-Kuang
authors.initials: HK
authors.lastname: Wang
authors.affiliation: Institute of Clinical Medicine, National Cheng Kung University, Tainan, Taiwan. yuanyow@mail.ncku.edu.tw.
authors.forename: Yuan-Yow
authors.initials: YY
authors.lastname: Chiou
mesh_terms: D002454:Cell Differentiation; D004847:Epithelial Cells / Q000473:pathology*; D058750:Epithelial-Mesenchymal Transition; D004848:Epithelium / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis; D010537:Peritoneum / Q000473:pathology*; D051436:Renal Insufficiency, Chronic / Q000473:pathology* / Q000628:therapy*; D013997:Time Factors; D016896:Treatment Outcome