-
International Journal of Molecular... Jul 2020Peritoneal dialysis (PD) is an established home care, cost-effective renal replacement therapy (RRT), which offers several advantages over the most used dialysis... (Review)
Review
Peritoneal dialysis (PD) is an established home care, cost-effective renal replacement therapy (RRT), which offers several advantages over the most used dialysis modality, hemodialysis. Despite its potential benefits, however, PD is an under-prescribed method of treating uremic patients. Infectious complications (primarily peritonitis) and bio-incompatibility of PD solutions are the main contributors to PD drop-out, due to their potential for altering the functional and anatomical integrity of the peritoneal membrane. To improve the clinical outcome of PD, there is a need for biomarkers to identify patients at risk of PD-related complications and to guide personalized interventions. Several recent studies have shown that proteomic investigation may be a powerful tool in the prediction, early diagnosis, prognostic assessment, and therapeutic monitoring of patients on PD. Indeed, analysis of the proteome present in PD effluent has uncovered several proteins involved in inflammation and pro-fibrotic insult, in encapsulating peritoneal sclerosis, or even in detecting early changes before any measurable modifications occur in the traditional clinical parameters used to evaluate PD efficacy. We here review the proteomic studies conducted thus far, addressing the potential use of such omics methodology in identifying potential new biomarkers of the peritoneal membrane welfare in relation to dialytic prescription and adequacy.
Topics: Biomarkers; Humans; Peritoneal Dialysis; Peritoneum; Peritonitis; Prognosis; Proteome; Proteomics; Renal Dialysis
PubMed: 32752018
DOI: 10.3390/ijms21155489 -
Cellular Immunology Aug 2018For decades, it has been known that the serous cavities, which include the peritoneal, pleural and pericardial cavities, harbour large numbers of macrophages. In... (Review)
Review
For decades, it has been known that the serous cavities, which include the peritoneal, pleural and pericardial cavities, harbour large numbers of macrophages. In particular, due to the ease of isolating these cells, the peritoneal cavity has been used as a convenient source of macrophages to examine many facets of macrophage biology over the last 50-60 years. Despite this, it is only recently that the true heterogeneity of serous cavity mononuclear phagocyte compartment, which includes macrophages and dendritic cells, has been revealed. Advances in technologies such as multi-parameter flow cytometry and the 'OMICs' revolution have uncovered the presence of distinct populations of mononuclear phagocytes in the serous cavities. Given that peritoneal macrophages have been implicated in many pathologies, including peritonitis, pancreatitis, endometriosis and acute liver injury, it is imperative to understand the biology of these cells. Here, we review the recent advances in understanding the identity, origin and function of discrete serous cavity mononuclear phagocyte subsets in homeostasis and how these may change when homeostasis is perturbed, focusing on peritoneal and pleural cavities and highlighting differences in the mononuclear phagocytes found in each.
Topics: Animals; Homeostasis; Humans; Macrophages; Pericardium; Peritoneum; Peritonitis; Phagocytes; Pleural Cavity
PubMed: 29397065
DOI: 10.1016/j.cellimm.2018.01.003 -
Surgical and Radiologic Anatomy : SRA Mar 2015Although several studies have reported that the peritoneum does not contribute to the formation of a fascia between the urogenital organs and rectum, Denonvilliers'...
Although several studies have reported that the peritoneum does not contribute to the formation of a fascia between the urogenital organs and rectum, Denonvilliers' fascia (DF), a fascia between the mesorectum and prostate (or vagina) in adults, is believed to be a remnant of the peritoneum. Remnants of the peritoneum, however, were reportedly difficult to detect in other fusion fasciae of the abdominopelvic region in mid-term fetuses. To examine morphological changes of the pelvic cul-de-sac of the peritoneum, we examined 18 male and 6 female embryos and fetuses. A typical cul-de-sac was observed only at 7 weeks, whereas, at later stages, the peritoneal cavity did not extend inferiorly to the level of the prostatic colliculus or the corresponding structure in females. The cul-de-sac had completely disappeared in front of the rectum at 8 weeks and homogeneous and loose mesenchymal tissue was present in front of the rectum at the level of the colliculus at 12-16 weeks. We found no evidence that linearly arranged mesenchymal cells developed into a definite fascia. Therefore, the development of the DF in later stages of fetal development may result from the mechanical stress on the increased volumes of the mesorectum, seminal vesicle, prostate and vagina and/or enlarged rectum. Therefore, we considered the DF as a tension-induced structure rather than a fusion fascia. Fasciae around the viscera seemed to be classified into (1) a fusion fascia, (2) a migration fascia and (3) a tension-induced fascia although the second and third types are likely to be overlapped.
Topics: Cadaver; Fascia; Female; Fetus; Humans; Male; Pelvis; Peritoneum; Rectum; Stress, Mechanical
PubMed: 25008480
DOI: 10.1007/s00276-014-1336-0 -
Radiographics : a Review Publication of... 2019Encapsulating peritoneal sclerosis (EPS) is a rare but serious condition that results in (a) encapsulation of bowel within a thickened fibrocollagenous peritoneal... (Review)
Review
Encapsulating peritoneal sclerosis (EPS) is a rare but serious condition that results in (a) encapsulation of bowel within a thickened fibrocollagenous peritoneal membrane and (b) recurrent episodes of bowel obstruction. Although described by various names in the literature, the preferred term is encapsulating peritoneal sclerosis because it best describes the morphologic and histologic changes in this disorder. The etiology of EPS is multifactorial, with a wide variety of implicated predisposing factors that disrupt the normal physiologic function of the peritoneal membrane-prime among these factors being long-term peritoneal dialysis and bacterial peritoneal infections, especially tuberculosis. The clinical features of EPS are usually nonspecific, and knowledge of the radiologic features is necessary to make a specific diagnosis. The findings on radiographs are usually normal. Images from small-bowel follow-through studies show the bowel loops conglomerated in a concertina-like fashion with a serpentine arrangement in a fixed U-shaped configuration. US demonstrates a "cauliflower" appearance of bowel with a narrow base, as well as a "trilaminar" appearance depicted especially with use of high-resolution US probes. CT is the imaging modality of choice and allows identification of the thickened contrast material-enhanced abnormal peritoneal membrane and the encapsulated clumped bowel loops. In addition, CT can potentially help identify the cause of EPS (omental granuloma in tuberculosis), as well as the complications of EPS (bowel obstruction). Conservative medical treatment and surgical therapy early in the course of EPS have been used for management of the condition. The purpose of this article is to review the nomenclature and etiopathogenesis of EPS, describe the multimodality imaging appearances of EPS, including differentiating its features from those of other conditions mimicking EPS, and give an overview of management options. Online DICOM image stacks are available for this article. RSNA, 2018.
Topics: Barium Radioisotopes; Diagnosis, Differential; Humans; Intestinal Obstruction; Intestines; Magnetic Resonance Imaging; Peritoneal Dialysis; Peritoneal Fibrosis; Peritoneum; Prognosis; Radiography; Tomography, X-Ray Computed
PubMed: 30526331
DOI: 10.1148/rg.2019180108 -
International Review of Cell and... 2022The peritoneal cavity is a fluid-packed area that houses most of the abdominal organs, including the omentum, a visceral adipose tissue with milky patches or groups of...
The peritoneal cavity is a fluid-packed area that houses most of the abdominal organs, including the omentum, a visceral adipose tissue with milky patches or groups of leukocytes organized in the same way to those observed in typical lymphoid tissues. A distinct population of leukocytes patrols the peritoneal cavity and travels in and out of the milky spots, facing antigens or pathogens in the peritoneal fluid and responding appropriately. T cells may play a crucial function in regulating adaptive immune responses to antigens in the peritoneal cavity to ensure tissue homeostasis and healing. When peritoneal homeostasis is interrupted by inflammation, infection, obesity, or tumor metastasis, the omentum's dedicated fibroblastic stromal cells and mesothelial cells control peritoneal leukocyte recruitment and activation in unique ways. T cells, which employ their T cell receptor to target specific antigens, are an important component of the acquired immune response since they are present in the peritoneal cavity. The peritoneum provides a different environment for T cells to respond to pathogens. This chapter outlines the anatomy relevant to T cell function and biology, such as antigen processing/presentation, T cell activation, and the many T cell subpopulations in the peritoneal cavity, as well as their role in cancer or other infection.
Topics: Lymphocyte Activation; Lymphoid Tissue; Omentum; Peritoneum; T-Lymphocytes
PubMed: 35964999
DOI: 10.1016/bs.ircmb.2022.04.013 -
Fertility and Sterility Oct 2016The mesothelium was traditionally thought to be a simple tissue with the sole function of providing a slippery, nonadhesive, and protective surface to allow easy... (Review)
Review
The mesothelium was traditionally thought to be a simple tissue with the sole function of providing a slippery, nonadhesive, and protective surface to allow easy movement of organs within their body cavities. However, our knowledge of mesothelial cell physiology is rapidly expanding, and the mesothelium is now recognized as a dynamic cellular membrane with many other important functions. When injured, mesothelial cells initiate a cascade of processes leading either to complete regeneration of the mesothelium or the development of pathologies such as adhesions. Normal mesothelial healing is unique in that, unlike with other epithelial-like surfaces, healing appears diffusely across the denuded surface, whereas for epithelium healing occurs solely at the wound edges. This is because of a free-floating population of mesothelial cells which attach to the injured serosa. Taking advantage of this phenomenon, intraperitoneal injections of mesothelial cells have been assessed for their ability to prevent adhesion formation. This review discusses some of the functions of mesothelial cells regarding maintenance of serosal integrity and outlines the mechanisms involved in mesothelial healing. In addition, the pathogenesis of adhesion formation is discussed with particular attention to the potential role of mesothelial cells in both preventing and inducing their development.
Topics: Animals; Epithelial Cells; Epithelium; Female; Homeostasis; Humans; Male; Peritoneum; Risk Factors; Signal Transduction; Surgical Procedures, Operative; Tissue Adhesions; Treatment Outcome; Wound Healing
PubMed: 27692285
DOI: 10.1016/j.fertnstert.2016.09.005 -
Current Problems in Cancer 2017Multicystic peritoneal mesothelioma (MCPM) is a rare neoplasm, predominantly affecting female patients during their reproductive years. The lesion is usually distributed... (Review)
Review
Multicystic peritoneal mesothelioma (MCPM) is a rare neoplasm, predominantly affecting female patients during their reproductive years. The lesion is usually distributed diffusely in the abdomen and pelvis, but the peritoneum of the pelvic organs is the most common site. MCPM is composed of fluid-filled translucent cysts, connected by varying amounts of fibrous tissue, and lined by a layer of mesothelial cells. Because of the rarity of this disease, the pathogenesis and natural history of MCPM remain poorly understood and continuously debated. Some authors consider it to be a reactive process for its association with prior surgery or abdominal inflammation. But its high rate of local-regional recurrence, as well as its malignant potential, suggests a neoplastic etiology. Preoperative diagnosis is often very difficult. Imaging methods, such as ultrasound, computed tomography, and magnetic resonance imaging, are of little value for an accurate diagnosis of MCPM. The definitive diagnosis relies on histologic examination of target lesions combined with immunohistochemical stains. There is no consensus on the clinical management of MCPM, although surgical removal remains the first-line treatment of choice. But no standards have been reached concerning which surgical options-traditional debulking surgery or more aggressive one-should be chosen. Alternative therapeutic approaches include hand-off treatment, hormonal supplementation, laser vaporization, and sclerotherapy, and they all come with uncertain results. Moreover, the lesions show no response to adjuvant chemotherapy and radiotherapy. This article aimed to focus on those controversial problems in pathogenesis, natural history, diagnosis, and treatment strategies to help medical workers to better understand this rare disease.
Topics: Antineoplastic Agents, Hormonal; Chemoradiotherapy, Adjuvant; Cytoreduction Surgical Procedures; Epithelial Cells; Female; Humans; Male; Mesothelioma, Cystic; Neoplasm Recurrence, Local; Peritoneal Neoplasms; Peritoneum; Rare Diseases; Sex Factors; Treatment Outcome
PubMed: 28528021
DOI: 10.1016/j.currproblcancer.2017.03.002 -
ANZ Journal of Surgery Apr 2019Penetrating abdominal trauma is uncommon in Australia. There are multiple potential approaches to the patient without an indication for immediate laparotomy. This study... (Review)
Review
BACKGROUND
Penetrating abdominal trauma is uncommon in Australia. There are multiple potential approaches to the patient without an indication for immediate laparotomy. This study examined the management of patients with a penetrating anterior abdominal injury in a Level 1 trauma centre, and in particular investigated the outcomes of those patients who underwent diagnostic laparoscopy.
METHODS
A retrospective review was undertaken of all patients presenting to a Level 1 trauma centre with an anterior abdominal stab wound over a 15-year period. Patient demographic, injury, examination, treatment and outcome data were extracted. These data were analysed using SPSS PASW version 20.
RESULTS
A total of 318 patients were identified. Immediate laparotomy was performed in 121 of those patients. Of the remaining 197 patients, 146 underwent diagnostic laparoscopy. Peritoneal breach was identified in 87 patients, 79 of whom then had exploratory laparotomy. The laparotomy was therapeutic in 36 of 79 patients (45.6%). Multiple stab wounds were an independent predictor of therapeutic laparotomy (hazard ratio 2.39, 95% CI 1.16-4.93). Diagnostic laparoscopy was 100% sensitive, 60.9% specific and had a negative predictive value of 100% and a positive predictive value of 40%. Non-therapeutic laparotomy was associated with a median length of stay of 5.5 days and a complication rate of 9.3%.
CONCLUSION
Diagnostic laparoscopy to detect peritoneal breach is a safe approach in the management of anterior abdominal stab wounds. However, utilizing peritoneal breach as an indication for laparotomy is associated with a moderate incidence of non-therapeutic laparotomy. Measures to decrease the negative laparotomy rate should be considered.
Topics: Abdominal Injuries; Adult; Australia; Humans; Laparoscopy; Laparotomy; Length of Stay; Peritoneum; Pneumonia; Predictive Value of Tests; Retrospective Studies; Trauma Centers; Wounds, Penetrating; Wounds, Stab
PubMed: 30873735
DOI: 10.1111/ans.15140 -
Pediatric Radiology Jul 2017The normal peritoneal structures, including the mesenteries and the omenta, are only a few cell layers thick and are visible on imaging based upon the tissues (e.g.,... (Review)
Review
The normal peritoneal structures, including the mesenteries and the omenta, are only a few cell layers thick and are visible on imaging based upon the tissues (e.g., fat) and structures (e.g., blood vessels and lymph nodes) contained within them. These structures become more visible and change in appearance when involved by pathological processes. In this pictorial essay, we discuss the normal anatomy of the various abdominopelvic peritoneal structures and illustrate numerous developmental and acquired diagnoses that involve these structures in the pediatric and young adult population.
Topics: Child; Humans; Mesentery; Omentum; Peritoneum
PubMed: 28646385
DOI: 10.1007/s00247-017-3864-3 -
Communications Biology Aug 2021The position of abdominal organs, and mechanisms by which these are centrally connected, are currently described in peritoneal terms. As part of the peritoneal model of...
The position of abdominal organs, and mechanisms by which these are centrally connected, are currently described in peritoneal terms. As part of the peritoneal model of abdominal anatomy, there are multiple mesenteries. Recent findings point to an alternative model in which digestive organs are connected to a single mesentery. Given that direct evidence of this is currently lacking, we investigated the development and shape of the entire mesentery. Here we confirm that, within the abdomen, there is one mesentery in which all abdominal digestive organs develop and remain connected to. We show that all abdominopelvic organs are organised into two, discrete anatomical domains, the mesenteric and non-mesenteric domain. A similar organisation occurs across a range of animal species. The findings clarify the anatomical foundation of the abdomen; at the foundation level, the abdomen comprises a visceral (i.e. mesenteric) and somatic (i.e. musculoskeletal) frame. The organisation at that level is a fundamental order that explains the positional anatomy of all abdominopelvic organs, vasculature and peritoneum. Collectively, the findings provide a novel start point from which to systemically characterise the abdomen and its contents.
Topics: Humans; Mesentery; Peritoneum
PubMed: 34408242
DOI: 10.1038/s42003-021-02496-1