Abstract: Objective To explore the effects of high glucose on the expression of glycocalyx including hyaluronic acid (HA) and decorin (DCN), inflammatory and fibrosis factors including IL-6 and TGF-β1 in human peritoneal mesothelial cells (HPMCs), and to observe the effects of sulodexide (SLX) on these changes in HPMCs. Methods HPMCs were randomly assigned into control group, high glucose group and high glucose+ SLX group. In the high glucose group, HPMCs were divided into different concentrations of glucose subgroups (HPMCs stimulated with 1.5%, 2.5% and 4.25% glucose for 48 hours) and different stimulation time subgroups (HPMCs stimulated with 2.5% glucose for 0, 6, 12, 24, 48 and 72 hours). In the high glucose+ SLX group, HPMCs were treated with 2.5% glucose and 50, 400, 800, 1200 μg/ml SLX for 48 hours. HA, DCN, IL-6 and TGF-β1 in the cultured media were assayed by ELISA. Results ①Compared to the control group, different concentrations of high glucose up-regulated the expressions of HA (172.074±3.223pg/ml vs. 147.000±1.667pg/ml, F=20.410, P=0.036), DCN (2.435±0.150ng/ml vs. 1.021±0.138ng/ml, F=219.555, P=0.000), IL-6 (67.981±1.655ng/l vs. 45.637±1.143ng/l, F=160.674, P=0.000) and TGF-β1 (204.691±2.829ng/l vs. 112.716±7.484ng/l, F=1692.284, P =0.000) in HPMCs. High concentrations of glucose for different hours also up- regulated the expression of HA (205.986 ± 2.746pg/ml vs. 147.000 ± 1.667pg/ml, F=1225.533, P=0.000), DCN (1.422±0.134ng/ml vs. 1.021± 0.138ng/ml, F=112.124, P=0.001), IL-6 (68.078±2.944ng/l vs.45.637±1.143ng/l, F=69.690, P=0.000), and TGF-β1 (194.816±1.854ng/l vs. 112.716±7.484ng/l, F=1160.819, P =0.000) in HPMCs. ② Compared to the high glucose group, treatment of SLX further increased the expression of HA (196.119±2.260pg/ml vs. 172.074±3.223pg/ml, F=120.845, P=0.013) and DCN (3.227±0.067ng/ml vs. 2.859±0.175ng/ml, F=15.413, P=0.008), but down-regulated the expression of IL-6 (67.927±2.467ng/l vs. 75.371 ± 2.386ng/l, F=50.643, P=0.002) and TGF- β1 (232.778 ± 31.029ng/l vs. 292.347 ± 3.857ng/l, F=21.458, P=0.002). Conclusion HPMCs expressed HA and DCN. Treatment of SLX further increased the high glucose induced up- regulation of HA and DCN, which may repair the injured activity of glycocalyx. SLX could reverse the high glucose induced up-regulation of IL-6 and TGF-β1 in HPMCs, which may protect peritoneal function through the inhibition of peritoneal inflammation and fibrosis.

Key words: HPMCs, Glycocalyx, SLX, HA, DCN, IL-6, TGF-β1