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Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Nephrol. May 6, 2017; 6(3): 111-118
Published online May 6, 2017. doi: 10.5527/wjn.v6.i3.111
Targeting cannabinoid signaling for peritoneal dialysis-induced oxidative stress and fibrosis
Chih-Yu Yang, Yat-Pang Chau, Ann Chen, Oscar Kuang-Sheng Lee, Der-Cherng Tarng, An-Hang Yang
Chih-Yu Yang, Der-Cherng Tarng, Division of Nephrology, Department of Medicine, Taipei Veterans General Hospital, Taipei 11217, Taiwan
Chih-Yu Yang, Oscar Kuang-Sheng Lee, Der-Cherng Tarng, An-Hang Yang, School of Medicine, National Yang-Ming University, Taipei 11221, Taiwan
Chih-Yu Yang, Oscar Kuang-Sheng Lee, Der-Cherng Tarng, An-Hang Yang, Institute of Clinical Medicine, National Yang-Ming University, Taipei 11221, Taiwan
Yat-Pang Chau, Faculty of Medicine, Mackay Medical College, New Taipei City 25245, Taiwan
Ann Chen, Department of Pathology, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
Oscar Kuang-Sheng Lee, Department of Orthopedic Surgery, Taipei City Hospital, Taipei 10629, Taiwan
Oscar Kuang-Sheng Lee, Stem Cell Research Center, National Yang-Ming University, Taipei 11221, Taiwan
Oscar Kuang-Sheng Lee, Department of Medical Research and Department of Orthopedic Surgery, Taipei Veterans General Hospital, Taipei 11217, Taiwan
An-Hang Yang, Department of Pathology, Taipei Veterans General Hospital, Taipei 11217, Taiwan
Author contributions: All authors contributed to this paper.
Supported by The Ministry Of Science and Technology, Taiwan, Nos. NSC 96-2628-B-075-003-MY3, MOST 104-2314-B-075-031, and MOST 105-2628-B-075-008-MY3; a grant from Taipei Veterans General Hospital, Taipei, Taiwan, No. V106D25-003-MY3-1; Taipei Veterans General Hospital, National Yang-Ming University Excellent Physician Scientists Cultivation Program, No. 103-V-B-024.
Conflict-of-interest statement: None.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. An-Hang Yang, Institute of Clinical Medicine, National Yang-Ming University, No. 201, Section 2, Shih-Pai Road, Taipei 11221, Taiwan. ahyang@vghtpe.gov.tw
Telephone: +886-2-28757090 Fax: +886-2-28757056
Received: November 4, 2016
Peer-review started: November 9, 2016
First decision: November 30, 2016
Revised: January 28, 2017
Accepted: February 18, 2017
Article in press: February 20, 2017
Published online: May 6, 2017
Processing time: 181 Days and 7 Hours
Abstract

Long-term exposure to bioincompatible peritoneal dialysis (PD) solutions frequently results in peritoneal fibrosis and ultrafiltration failure, which limits the life-long use of and leads to the cessation of PD therapy. Therefore, it is important to elucidate the pathogenesis of peritoneal fibrosis in order to design therapeutic strategies to prevent its occurrence. Peritoneal fibrosis is associated with a chronic inflammatory status as well as an elevated oxidative stress (OS) status. Beyond uremia per se, OS also results from chronic exposure to high glucose load, glucose degradation products, advanced glycation end products, and hypertonic stress. Therapy targeting the cannabinoid (CB) signaling pathway has been reported in several chronic inflammatory diseases with elevated OS. We recently reported that the intra-peritoneal administration of CB receptor ligands, including CB1 receptor antagonists and CB2 receptor agonists, ameliorated dialysis-related peritoneal fibrosis. As targeting the CB signaling pathway has been reported to be beneficial in attenuating the processes of several chronic inflammatory diseases, we reviewed the interaction among the cannabinoid system, inflammation, and OS, through which clinicians ultimately aim to prolong the peritoneal survival of PD patients.

Keywords: Reactive oxygen species; Peritoneal fibrosis; Peritoneal dialysis; Cannabinoid signaling; Oxidative stress

Core tip: Long-term exposure to bioincompatible peritoneal dialysis (PD) solutions frequently results in peritoneal fibrosis and ultrafiltration failure, which limits the life-long use of PD therapy. Beyond uremia per se, oxidative stress (OS) also results from chronic exposure to high glucose load, glucose degradation products, advanced glycation end products, and hypertonic stress in PD patients. Therapy targeting the cannabinoid signaling pathway has been reported in several chronic inflammatory diseases with elevated OS. In this article, we review the interaction among the cannabinoid system, inflammation, and OS, through which the health-care professionals ultimately aim to prolong the peritoneal survival of PD patients.