Objective To investigate the correlation between the secreted form of immune checkpoint programmed cell death ligand 1(PDL1)—soluble programmed cell death ligand 1(sPDL1)and the progression of peritoneal fibrosis(PF).Methods Peritoneal dialysis(PD)patients with different PD duration and PF degree were observed to detect the expression of PDL1 in exfoliated cells and the secretion of sPDL1 in plasma and PD fluid.Human peritoneal mesothelial cells(HPMC)were used to establish high glucose fibrosis model and lentivirus was used to down-regulate PDL1,and the correlation between PDL1/sPDL1 and mesothelial cell transdifferentiation was evaluated.Results sPDL1 was significantly up-regulated after PD treatment.Compared with PD fluid sPDL1,plasma sPDL1 was correlated with primary diseases and other factors.There was a positive correlation between PD fluid sPDL1 and PF level.Patients with high levels of sPDL1 were more likely to progress to the next stage of peritoneal function.There was a positive correlation between sPDL1 expression in PD fluid and PDL1 expression in exfoliated cells.Under high glucose stimulation,the expressions of PDL1 and sPDL1 were significantly increased in HPMC,and then the expressions of α-SMA and snail were up-regulated.After lentivirus down-regulation of PDL1 and sPDL1,α-SMA and snail in mesothelial cells were down-regulated accordingly.Conclusion PD fluid sPDL1 has a high correlation with PD treatment.The increase of sPDL1 in PD fluid may be an early sign of fibrosis,indicating the increase of peritoneal solute transport function.Under the induction of high glucose,sPDL1 is overexpressed in HPMC,which promotes cell transdifferentiation and induces the progression of PF.
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