Effect of N-acetylglucosamine on function of peritoneal leukocytes

Objective:To compare effects of N-acetylglucosamine (NAG)-based and glucose -based dialysis fluids on the function of peritoneal leukocytes in conditio ns of peritoneal dialysis. Design: In vitro experiments on ex vivo isolated rat peritoneal leukocytes. Materials: Peritoneal leukocytes were isolated from rats on chronic periton eal dialysis. On alternate days, fluid exchanges were performed with NAG-ba sed or glucose-based dialysis solutions. After a 4-hour dwell, dialysate wa s drained and peritoneal leukocytes were incubated in vitro +/- lipopolysac charide (LPS). Production of nitrites tinder of NO synthesis), tumor necros is factor alpha (TNF alpha), interleukin-1 beta (IL-1 beta), and interferon gamma (IFN-gamma) by unstimulated or stimulated peritoneal leukocytes orig inating from NAG-based or glucose-based fluid was measured. Results: Dialysate cell count was lower during exchanges with NAG-based flu id (2113 +/- 615 cells/mu L) as compared to glucose-based fluid (3643 +/- 1 108 cells/mu L; p < 0.01). Differential cell count was similar in both stud ied groups. Unstimulated peritoneal leukocytes from NAG-based dialysate pro duced more NO (nitrites) (0.65 +/- 0.07 mu mol per 10(6) cells) than did ce lls from glucose-based dialysate (0.26 +/- 0.09 mu mol per 10(6) cells, p < 0.01). Stimulated peritoneal leukocytes from NAG-based dialysate produced more cytokines than did cells from glucose-based dialysate:TNF alpha, 135.2 +/- 37.0 pg versus 70.2 +/- 21.8 pg per 106 cells respectively, p < 0.01; IL-1 beta, 143.2 +/- 60.9 pg versus 99.1 +/- 22.4 pg per 10(6) cells respec tively, p < 0.05; IFN-gamma, 16.2 +/- 12.5 pg versus 6.0 +/- 1.8 pg per 10( 6) cells respectively, p < 0.01. Conclusions:We demonstrated that rat peritoneal leukocytes exposed in vivo to NAG-based dialysis fluid have better ability to produce inflammatory med iators than do peritoneal leukocytes from the same donor, but exposed in vi vo to glucose-based dialysis solution.