Phosphatidylcholine A Physiological Modulator of the Peritoneal Membrane

Abstract

In 1982 Hills⁽¹⁾ demonstrated by thin-layer chromatography (TLC) that the fluid which naturally wets mesothelial membranes is a phospholipid consisting of 92% phosphatidylcholine. He called this phospholipid surface-active material (SAM). In 1985 Grahame⁽²⁾ suggested that SAM may play a role in the physiology of peritoneal dialysis. Surface-active material normally adheres to the visceral and parietal walls of the peritoneum and is kept in situ by the attraction between positively charged choline and the negatively charged mesothelium. We know that SAM is a strong surfactant; it causes the peritoneum to become water repellent and brings about mechanical lubrication of endoperitoneal organs. The layer of liquid stagnating on the peritoneal surface creates resistance⁽³⁾ to peritoneal transport and, consequently, the degree of resistance will vary according to the thickness of this layer.