The Peritoneum: Health, Disease, and Perspectives regarding Tissue Engineering and Cell Therapies

Our plain-English summary of The Peritoneum: Health, Disease, and Perspectives regarding Tissue Engineering and Cell Therapies, by R.J.F.C. do Amaral, K.D. Arcanjo, M.C. El-Cheikh, et al (Cells, Tissues, Organs, 2017).

The study

• Authors: R.J.F.C. do Amaral, K.D. Arcanjo, M.C. El-Cheikh, F.L. de Oliveira
• Journal: Cells, Tissues, Organs
• Published: 2017;204(5-6):211-217
• Type of article: Review
• Cited by: 11 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

There are several pathologies associated with the peritoneum, such as mesothelioma and peritonitis. Moreover, the peritoneum is widely used in ultrafiltration procedures, i.e., peritoneal dialysis, presenting advantages over hemodialysis. On the other hand, ultrafiltration failure may lead to dialysis-induced fibrosis and hypervolemia. Therefore, the pathophysiological study of this tissue is of extreme biomedical importance. Studies investigating the biology of the cells dwelling in the peritoneum wall provide evidence of their plasticity and progenitor features. For instance, both mesothelial and submesothelial cells present characteristics similar to mesenchymal stem cells, including osteogenic and adipogenic differentiation potential, support of extramedullary hematopoiesis, modulation of inflammatory responses, and regulation of tumor progression. Indeed, the participation of each cell type in peritoneal pathological and physiological phenomena is still under debate, especially regarding a possible differentiation pathway connecting these peritoneal cells. The primary aim of this review is to raise this discussion. In order to do so, we will firstly provide an overview of the peritoneum anatomy, histology, and ontology, and finally we will address how a better understanding of peritoneal cell biology may contribute to future cell therapy and tissue engineering approaches.

© 2017 S. Karger AG, Basel.

In plain English

This article is a review, not an original study, and it does not discuss asbestos. Mesothelioma is named once, in the abstract, as one of several diseases of the peritoneum, the lining of the abdomen. The review then describes the peritoneum's structure and development, and examines its mesothelial cells and the connective-tissue cells beneath them (submesothelial cells): their origins, repair after injury, and scarring linked to peritoneal dialysis. Studies it cites report that about 40% of peritoneal dialysis patients had ultrafiltration failure after 3 years of treatment. They also report that about 70% of patients with ultrafiltration failure and long-term peritoneal dialysis showed mesothelium loss and changes the authors interpret as cell transition. The review also describes the authors' own earlier laboratory work, in which submesothelial cells supported blood-cell formation in vitro. The authors wrote that where scarring cells in the peritoneum come from is uncertain. They concluded that peritoneal cells may become sources for tissue engineering and cell therapy, but that agreement on each cell type's role is far from reached.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Narrative review of published research on the biology of the peritoneum and its cells
• Who was studied: No study population of its own. The review covers published studies on peritoneal mesothelial and submesothelial cells, including cell-culture work, mouse and rat experiments, and studies of peritoneal dialysis patients.
• Exposure: Asbestos and asbestos fibers are not discussed. The conditions discussed are peritoneal dialysis and experimental peritoneal injury and fibrosis.
• Main results:
  • From a cited study (Baroni et al., 2012): approximately 40% of peritoneal dialysis patients had ultrafiltration failure after 3 years of treatment.
  • From a cited study (Del Peso et al., 2008): among patients with ultrafiltration failure and long-term exposure to peritoneal dialysis, approximately 70% showed mesothelium loss and cytokeratin-positive cells in the submesothelium. The review interprets this as indicating epithelial-to-mesenchymal transition.
  • In the authors' own earlier laboratory study (do Amaral et al., 2014), submesothelial stromal cells from the anterior peritoneal wall supported blood-cell formation (myelopoiesis) in vitro and could differentiate into bone and fat cell lineages.
  • The authors stated that the precise origin of the scar-forming cells (myofibroblasts) in peritoneal fibrosis is uncertain.
• The authors' conclusion: The authors concluded that recent findings advance the possibility of using peritoneal cells for tissue engineering and cell therapy, and the peritoneum itself as a natural bioreactor. They added that consensus on the role of each cell type is far from agreed.

Topics

Medical terms in this study, explained in our Lexicon: Peritoneum, Mesothelioma, Fibrosis, STEM, Histology.

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