T Helper 17/Regulatory T Cell Balance and Experimental Models of Peritoneal Dialysis-Induced Damage

Figure 2

Mechanisms of Th17/Treg-balance in the peritoneal cavity in PD. Th17 predominance. In the peritoneal cavity local factors activate dendritic cells, macrophages, and neutrophils to produce proinflammatory molecules (IL-6, TNFα, TGF-β, VEGF, chemokines, and prostaglandins). Immune cells and proinflammatory molecules are reciprocally activated; thus cells induce proinflammatory molecule release and vice versa. These molecules activate Th17 cells and IL-17 production, which may result in fibrosis and MMT. This occurs in the presence of continuously high TGF-β levels. In contrast, in the presence of inactive immune cells together with low IL-6 levels, Treg cells are activated, releasing IL-10 and TGF-β that may block MMT. Abbreviations: GDPs: glucose-derived products. IP: intraperitoneal. AGEs: advanced glycation end products.