Glucose suppresses peritoneal inflammatory reactions and mesothelial hyperplasia caused by intraperitoneal saline infusion.

In the past, we had observed that infusion of normal saline into the peritoneal cavity stimulates an inflammatory response. In the present study, we examined what effect the addition of glucose to normal saline would have on the peritoneal inflammatory response and change in peritoneal morphology. After catheter implantation, rats were infused intraperitoneally (i.p.) for 3 days with Dianeal 1.36% (Baxter Healthcare Corporation, Deerfield, IL, U.S.A.). Dialysate samples were collected on day 3 after a 4-hour dwell. Next, rats were exposed to either NaCl (n = 7) or NaCl with glucose 250 mmol/L (Glu, n = 7) twice daily for 4 weeks. After 2 weeks and 4 weeks of the study, dialysate samples were collected after a 4-hour dwell to analyze the activity of inflammatory reaction. At the end of the experiment, imprints of peritoneal mesothelium were taken. Control animals (C, n = 6) did not undergo catheter implantation or the dialysis procedure. The inflammatory reaction--cell count, cell differentiation, nitric oxide production, protein loss, and monocyte chemoattractant protein-1 (MCP-1) concentration in dialysate expressed as a percentage of the initial value--did not change during the study in rats exposed to NaCl. On the other hand, in Glu-treated animals, the protein concentration was decreased after 4 weeks of the study (74% +/- 23%, p < 0.05), as was MCP-1 (24% +/- 12%, p < 0.05). The nitrites concentration was decreased after 2 weeks (72% +/- 19%; p < 0.05). Intraperitoneal adhesions were found in 6 rats of the NaCl group (86%) and in only 4 rats (57%) of Glu group. In the NaCl rats, a higher density of mesothelial cells was observed (2792 +/- 510 cells/mm2) as compared with Glu rats (2028 +/- 561 cells/mm2; p < 0.05) and with control rats (1629 +/- 422 cells/mm2, p < 0.05). The NaCl group also showed a higher nucleus: cytoplasm surface ratio (0.25 +/- 0.03) as compared with the Glu group (0.18 +/- 0.02, p < 0.01) and with the control group (0.14 +/- 0.01, p < 0.01). Addition of glucose to normal saline suppresses the peritoneal inflammatory response and mesothelial hyperplasia occurring with intraperitoneal infusion of NaCl solution alone.