THE HOST'S INITIAL RESPONSE TO PERITONEAL INFECTION: THE PIVOTAL ROLE OF THE MESOTHELIAL CELL

T he past few years have seen a dramatic increase in our knowledge of the inflammatory processes occurring within the peritoneum of continuous ambulatory peritoneal dialysis ( CAPD) patients. In this respect, research and clinical observation have identified that an interlinked, temporal series of events occurs during the host's response to the infectious insult; this inflammatory cascade has been termed the "peritoneal cytokine network" (1). This research has also indicated that the interactions of the mesothelial cell, which lines the visceral and parietal peritoneum, and the peritoneal macrophages, which are resident within the peritoneal membrane, are of major significance to this inflammatory network. This they achieve via direct cell:cellinteraction, as well as via their secretion ofpro and anti-inflammatory cytokines, growth factors, prostaglandins, components of the fibrinolyti