JPS59501983A - Opsonins in peritoneal dialysis - Google Patents

Abstract

(57) [Summary] This bulletin contains application data before electronic filing, so abstract data is not recorded.

Description

[Detailed description of the invention] Opsonins in peritoneal dialysis 3′ hoe instep and ′-′4 knee Chronic peritoneal dialysis is a highly successful means of treating patients with end-stage renal disease.

The dialysate is pumped into the peritoneal cavity and allowed to remain for several hours, during which time it undergoes metabolic aging. Engage in dialysis across the peritoneum for waste removal. Dialysate is then removed from the peritoneal cavity, and for continuous ambulatory peritoneal dialysis, quickly exchanged with a new volume of new dialysate be done.

One significant drawback of various forms of peritoneal dialysis is that patients undergoing it may develop peritonitis. -It's easy to do. Although it is known that i-itis can be treated with antibiotics, Because of the susceptibility of the peritoneal cavity to infection, it is potentially among the most serious infections .

The present invention reduces the risk of peritonitis and its symptoms, particularly in patients undergoing peritoneal dialysis. A technique for suppressing peritonitis is provided.

Gai Honko ■Escape According to the present invention, opsonin against microorganisms is introduced into the patient's peritoneal cavity to suppress the symptoms of peritonitis. administered in a dosage sufficient to

It is known that the peritoneum contains white cells, particularly those known as peritoneal macrophages. It is being According to the invention, the addition of opsonin mixed with peritoneal dialysis fluid, for example, Increases the activity of white cells in the peritoneal cavity, they destroy a large number of bacteria, and therefore peritonitis Produces suppression of symptoms.

Although opsonins can be found naturally in the abdominal cavity, some patients experience abdominal pain when exposed to them. may appear to lack sufficient opsonin concentrations to effectively control hip inflammation. It is recognized that Artificial addition of opsonin to the peritoneal cavity suppresses peritoneal inflammation symptoms , in particular can be a valuable means of preventing its occurrence.

The type of opsonin that can be used in the method of the invention is, of course, limited by its toxicity, allergic reactions, etc. Subject to natural limitations with respect to others, but infinite. Broadly speaking, the term opsonin refers to a white, thin The task of changing the microorganisms so that the spores are more likely to feed on groupers, molds, etc. Regarding drugs of intent. Typical opsonins coat themselves or otherwise coat microorganisms. Facilitates the action of white cells that attach to, devour, and typically destroy It is believed that it will. For example, gamma globulin, a therapeutic blood fraction, , a known opsonin that is particularly effective against Durham-positive grouper terriers. also A therapeutic blood fraction known as an opsonin against Gram-negative bacteria. Other complements can also be used. Separated components of gamma globulin and complement , i.e. specific IgG antibodies (e.g. peptidoglycan antibodies) or complement C3B. Containing ingredients can also be used.

Opsonins can be administered into the peritoneal cavity in any desired manner, such as by injection. However, in the case of peritoneal dialysis fluid, there is a connection between the peritoneal cavity and the outside to administer opsonin. It is preferable to use a Di lumen catheter that communicates between the two. If you wish, Psonin is added to the peritoneal dialysate by mixing it with the dialysate immediately before administration. Can be added before administration. Instead, the opsonin is by the peritoneal dialysis fluid itself. There is no need to administer extra opsonin beyond what is supplied.

Peritoneal dialysis fluid containing opsonins such as gamma globulin or complement is optional. It is possible to have the opsonin present at a desired safe and effective concentration. for example, Gamma globulin or its components are present in the peritoneal dialysis fluid, and the concentration is 0.05 to i o+ng: Preferably may be present in a concentration not exceeding 5 mg. The 03 part of complement is The dialysate may be present in solution at a concentration of 0.1 to 10 mg. Also grams Because of its enhanced effectiveness against both positive and gram-negative bacteria, It is desirable that a mixture of immunoglobulin and complement at said concentration be present in the peritoneal dialysis fluid. Delicious.

Other possible opsonins, such as C-reactive protein or fibronectin can also be supplied to the peritoneal dialysis fluid or otherwise administered if desired.

The peritoneal dialysis fluid to which heopsonin is added should otherwise be a conventional prescription. It has a pH that is physiologically tolerable, and when placed into the patient's abdominal cavity, Have physiological salts and osmotic agents at safe and effective concentrations to perform membrane dialysis There is. Typically 1 to 5% by weight of glucose is present as an osmotic agent. The ions of physiological salts are sodium, calcium, magnesium, and chloride. , acetic acid and lactic acid, for example, in conventional concentrations. Potassium ions and and other physiologically acceptable! - The resulting ions may also be present if appropriate.

■Dish■Sekisato Figure 1 shows a peritoneal dialysis 7Pi, a container in communication with the patient's peritoneal cavity using conventional equipment. FIG.

Shiyodo J3 Taidozu 81 Skin Referring to the drawings, a container 10 of peritoneal dialysis fluid is shown in the Deerfield, Ill. Trahenol, commercially available from Laboratories, Inc. It can be anything by design. Container 10 is commercially available from the same company and Communicates with a conventional Tenkhosoff catheter 14 permanently implanted in the peritoneal cavity of patient 15 It communicates with the Zuru transfer set 12. As previously mentioned, the solution contents of container 10 ( Typically 2A) is delivered through set 12 and catheter 14 into the peritoneal cavity. and the cent is closed with a clamp 16 so that the solution remains in it. be done. The patient then folds or rolls the flexible container 10 into a small package and It can be worn in compact form under his clothes for about 4 hours. the The patient then unfolds container 10, opens catheter 14, and removes the used catheter in a conventional manner. Allow dialysate to drain into container 10. Then he clamps container 10 Close it with a new container of fresh dialysate, remove it from the Replace.

A typical peritoneal dialysis solution that can be used in the present invention is 100m! per Q, U.S. Pharmacopoeia water-containing de Kistrose 1.5 to 4.25g, USP sodium chloride 50011g, milk Acid sodium 448■, rice layer calcium chloride 25.7mg, and US pharmacopoeia salt Contains 5.08 g of magnesium chloride.

The pH is preferably about 5.5 or may broadly range from about pH 5 to 70.

According to the present invention, gamma globulin present in 10'OITIg per dialysate β is An auxiliary dose, which may be of conventional design, is added to mix with the peritoneal dialysis fluid present in container 10. The drug can be added to the container 10 by means of a syringe barrel 20 through the drug boat 18 .

Instead, the C-3 component of 100 μl of complement per dialysate β may be part of the total complement or can be added as a purified fraction thereof. Instead, per l Question C-3 component 100■ is added to a solution as a separate additive along with gamma globulin. may be done.

Thereafter, administration of dialysate into the peritoneal cavity allows peritoneal dialysis to proceed in the usual manner, but only The presence of opsonins increases white cell phagocytosis and any bacteria present. Symptoms of peritonitis are effective because they cause the subsequent destruction of microorganisms or other microorganisms. is suppressed.

The foregoing is provided for illustrative purposes only and does not apply to the book specified in the claims. It is not intended to limit the scope of the invention.

Claims (1)

[Claims] 1. microorganisms into the patient's peritoneal cavity at doses sufficient to suppress symptoms of peritonitis. A method of administering opsonins against. 2. The method of item 1, wherein the opsonin contains gamma globulin. 3. The method of item 1, wherein the opsonin contains complement. 4. Administering peritoneal dialysis solution into the patient's peritoneal cavity, and then removing the solution from the peritoneal cavity. A method for performing peritoneal dialysis on a patient by adding peritonitis to the peritoneal dialysis fluid Addition of opsonins against microorganisms at concentrations sufficient to suppress symptoms. More improvements. 5. The method of item 4, wherein the opsonin includes gamma globulin. 6. The method of item 4, wherein the opsonin comprises complement. 7. The method of item 4, wherein the opsonin comprises a mixture of gamma globulin and complement. 8. At a concentration that is safe and effective for performing peritoneal dialysis when inserted into the patient's peritoneal cavity. consisting of an aqueous solution at a physiologically tolerable pH with physiological salts and osmotic agents. Suppresses symptoms of peritonitis when peritoneal dialysis fluid is injected into the peritoneal cavity during peritoneal dialysis operation an agent against microorganisms dispersed in said peritoneal dialysis fluid in a concentration sufficient to Improvement consisting of containing psonin. 9. The peritoneal dialysis solution according to item 8, wherein the opsonin contains gamma globulin. 10. The gamma globulin exists in the dialysate at a concentration of 0.05 to 10 μm. The peritoneal dialysis solution of item 9. 11. The peritoneal dialysis solution according to item 8, wherein the opsonin contains a sleeve. 12. The sleeve body is present at a p degree of 0.1 to 10 μ per precipitate. peritoneal dialysis fluid. 13. The opsonin contains 0.1 to 10 gamma glopurines per dialysate bottle. Peritoneal dialysis fluid according to paragraph 8, containing a mixture of 0.1 to 10 mg of complement. 14. When introduced into the patient's peritoneal cavity, the concentration is safe and effective for performing peritoneal dialysis. consisting of an aqueous solution at a physiologically tolerable pH with physiological salts and osmotic agents. In the peritoneal dialysis fluid, the peritoneal dialysis fluid is against microorganisms containing at least one peptidoglycan antibody dispersed in the analysis solution. An improvement consisting of containing an opsonin. 15. The peritoneal dialysis fluid according to item 14, in which less than 5 ml of the dispersed antibodies are present.