The effects of tacrolimus and mycophenolate mofetil on regression of encapsulating peritoneal sclerosis in a rat model

  • Bülent Huddam Mugla Sitki Kocman University, School of Medicine, Department of Nephrology, Mugla, Turkey
  • Simge Sasmaz Hitit University Erol Olçok Training and Research Hospital, Department of Internal Medicine, Çorum, Turkey
  • Nihan Haberal Baskent University, Faculty of Medicine, Department of Pathology, Ankara, Turkey
  • Alper Azak Ministry of Health, Balikesir State Hospital, Nephrology, Balikesir, Turkey
  • Dilek Gibyeli Genek Mugla Sitki Kocman University, School of Medicine, Department of Nephrology, Mugla, Turkey
  • Gulay Kocak Ministry of Health, Okmeydani Training and Research Hospital, Nephrology, Istanbul, Turkey
  • Volkan Karakus Alanya Alaaddin Keykubat University, Faculty of Medicine, Department of Hematology, Alanya-Antalya, Turkey
  • Alper Alp Mugla Sitki Kocman University, School of Medicine, Department of Nephrology, Mugla, Turkey
  • Murat Duranay Ankara Education and Research Hospital, Department of Nephrology, Ankara, Turkey
Keywords: renal dialysis, peritoneal dialysis, encapsulating peritoneal sclerosis, tacrolimus, mycophenolate mofetil

Abstract

Objective: Encapsulating peritoneal sclerosis (EPS) is a rare, but potentially fatal complication of peritoneal dialysis. Currently, treatment of peritoneal fibrosis is not fully possible yet. In this study, we aimed to demonstrate the effects of tacrolimus therapy on peritoneal fibrosis and inflammation when administered alone or with mycophenolate mofetil (MMF) in the EPS model induced in rats. Methods: Thirty six Wistar albino rats were separated into six equal groups. Group I was the control group. Group II-VI were administered intraperitoneal chlorhexidine (CH) for induced EPS model in rats. Group II, IV, V, VI were administered isotonic liquid, tacrolimus, tacrolimus and concurrently with CH, tacrolimus and MMF together, respectively. Group III was not administered any drug. All peritoneal samples were stained immunohistochemically with matrix metalloproteinase-2 (MMP-2) antibody. Thickness of peritoneal fibrosis, subserosal large collagen fibers, subserosal fibroblast proliferation and subserosal fibrotic matrix deposition were evaluated. Results: Comparing the experimentally induced EPS groups, the best histopathological results and the largest staining with MMP-2 were achieved in Group VI. Furthermore, in all treatment groups (IV, V, VI) more staining with MMP-2 was detected compared to non-treatment groups (I, II, III) but no statistically significant differences were found among all groups. A statistically significant remission was observed in all histopathological parameters, primarily peritoneal thickness in rats that were administered MMF with tacrolimus, compared to rats which were administered tacrolimus only. Conclusion: Concurrent use of tacrolimus and MMF in the treatment of EPS may be a promising approach.

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Published
2021-12-06
How to Cite
1.
Huddam B, Sasmaz S, Haberal N, Azak A, Gibyeli Genek D, Kocak G, Karakus V, Alp A, Duranay M. The effects of tacrolimus and mycophenolate mofetil on regression of encapsulating peritoneal sclerosis in a rat model. Rev Nefrol Dial Traspl. [Internet]. 2021Dec.6 [cited 2024Dec.21];41(4):264-7. Available from: http://revistarenal.org.ar/index.php/rndt/article/view/715
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Vol. 41 No. 4 (2021): Oct. - Dic.
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Original Article

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