BACKGROUND: Encapsulating peritoneal sclerosis (EPS) is an infrequent but extremely serious complication of long-term peritoneal dialysis. Fibrosis of the submesothelial compact zone and neoangiogenesis underlie the pathophysiology of EPS. Colchicine is a well-known anti-inflammatory and antifibrotic agent that has been used for some fibrosing clinical states, such as liver fibrosis. OBJECTIVE: To determine the antifibrotic and anti-inflammatory effects of colchicine in an EPS rat model in both progression (P) and regression (R). METHODS: 48 nonuremic albino Wistar rats were divided into 5 groups: control group, 2 mL isotonic saline intraperitoneally (IP) daily for 3 weeks; CG group, IP injection of 2 mL/200 g chlorhexidine gluconate (CG) (0.1%) and ethanol (15%) dissolved in saline, daily for 3 weeks; resting group, CG (0 - 3 weeks) + peritoneal resting (4 - 6 weeks); C-R group, CG (0 - 3 weeks) + 1 mg/L colchicine (4 - 6 weeks); C-P group, CG (0 - 3 weeks) + 1 mg/L colchicine in drinking water (0 - 3 weeks). At the end, a 1-hour peritoneal equilibration test was performed with 25 mL 3.86% peritoneal dialysis solution. Dialysate-to-plasma ratio of urea (D/P urea), dialysate WBC count, ultrafiltration volume, and morphological changes of parietal peritoneum were examined. RESULT: Exposure to CG for 3 weeks resulted in alterations in peritoneal transport (increased D/P urea, decreased ultrafiltration volume; p < 0.05) and morphology (increased inflammation, neovascularization, fibrosis, and peritoneal thickness; p < 0.05). Resting had some beneficial effects on peritoneal derangements; however, once the peritoneum had been stimulated, resting alone was not enough to reverse these pathological changes. Colchicine had more pronounced effects on membrane integrity via decreased inflammation, cell infiltration, and vascularity compared to the resting group. CONCLUSION: We suggest that colchicine may have therapeutic value in the management of EPS.
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机译：背景：封装性腹膜硬化症（EPS）是长期腹膜透析的一种罕见但极为严重的并发症。间皮下致密区的纤维化和新血管生成是EPS的病理生理基础。秋水仙碱是一种众所周知的抗炎和抗纤维化剂，已用于某些纤维化的临床状态，例如肝纤维化。目的：测定秋水仙碱在EPS大鼠模型中的抗纤维化和抗炎作用，包括进展（P）和消退（R）。方法：将48只非尿毒症的白化Wistar大鼠分为5组：对照组，每天腹膜内注射2mL等渗盐水，持续3周; CG组，IP注射2 mL / 200 g葡萄糖酸洗必太（CG）（0.1％）和乙醇（15％）溶于盐水，每天3周;静息组，CG（0-3周）+腹膜静息（4-6周）; C-R组，CG（0-3周）+ 1 mg / L秋水仙碱（4-6周）; C-P组，CG（0-3周）+饮用水中1 mg / L秋水仙碱（0-3周）。最后，用25 mL 3.86％腹膜透析液进行1小时腹膜平衡试验。检查尿素的透析液与血浆的比率（D / P尿素），透析液白细胞计数，超滤量和顶叶腹膜的形态变化。结果：暴露于CG 3周导致腹膜运输发生改变（D / P尿素增加，超滤量减少; p <0.05）和形态学改变（炎症，新血管形成，纤维化和腹膜厚度增加; p <0.05）。休息对腹膜紊乱有一些有益的影响。然而，一旦腹膜受到刺激，单靠休息不足以扭转这些病理变化。与静息组相比，秋水仙碱通过减少炎症，细胞浸润和血管形成，对膜的完整性有更明显的影响。结论：我们认为秋水仙碱可能在EPS的治疗中具有治疗价值。
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