{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T21:58:54Z","timestamp":1791583134923,"version":"4.3.4"},"reference-count":56,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T00:00:00Z","timestamp":1791417600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Perit Dial Int"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Glucose exposure in peritoneal dialysis contributes to local peritoneal membrane injury and systemic metabolic complications. The osmo-metabolic approach seeks to reduce glucose burden by using alternative osmotic agents such as xylitol and L-carnitine. PolyCore is a novel glucose-free bimodal peritoneal dialysis solution combining icodextrin (4%), xylitol (1.5%), and L-carnitine (0.02%), designed to provide sustained ultrafiltration while improving biocompatibility.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Human peritoneal mesothelial cells were exposed to PolyCore, icodextrin 7.5% solution, or a control medium. Cell viability, transepithelial electrical resistance, fibrosis-related gene expression, and \u03b1-SMA (alpha-smooth muscle actin) protein expression were assessed. In parallel, the EXCITE study was designed as a phase II, single-arm, prospective pilot trial evaluating PolyCore in 28 adults with end-stage kidney disease receiving incremental peritoneal dialysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>PolyCore preserved mesothelial cell viability and barrier integrity, with transepithelial resistance values comparable to control and significantly higher than icodextrin 7.5%. Compared with icodextrin 7.5%, PolyCore showed a more favorable expression profile of mesothelial-to-mesenchymal transition markers, with lower \u03b1-SMA and vimentin and preserved E-cadherin. The EXCITE study will assess safety and preliminary efficacy, including dialysis adequacy, ultrafiltration, solute removal, metabolic parameters, and patient-reported outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>PolyCore showed favorable in vitro biocompatibility compared with standard icodextrin 7.5% and may represent a glucose-free bimodal strategy for peritoneal dialysis. EXCITE will provide first clinical assessment on the safety and preliminary efficacy of PolyCore.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/08968608261493817","type":"journal-article","created":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T12:20:42Z","timestamp":1791462042000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["PolyCore, a bimodal peritoneal dialysis solution based on xylitol, L-carnitine, and icodextrin: In vitro evidence of the peritoneal membrane protection, rationale, and design of the phase II pilot study EXCITE"],"prefix":"10.1177","author":[{"given":"Silvio","family":"Borrelli","sequence":"first","affiliation":[{"name":"Unit of Nephrology, Department of Advanced Medical and Surgical Sciences, University of Campania \u201cLuigi Vanvitelli\u201d, Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina","family":"Masola","sequence":"additional","affiliation":[{"name":"University of Padova"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-0192-1723","authenticated-orcid":false,"given":"Tommaso","family":"Prosdocimi","sequence":"additional","affiliation":[{"name":"Department of Research and Development, Iperboreal Pharma, Pescara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4607-8554","authenticated-orcid":false,"given":"Richard","family":"Corbett","sequence":"additional","affiliation":[{"name":"Imperial College Healthcare NHS Trust"},{"name":"Department of Translational Medical Science, Imperial College London, University of Campania Luigi Vanvitelli, Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0622-6612","authenticated-orcid":false,"given":"Francesco","family":"Trepiccione","sequence":"additional","affiliation":[{"name":"Unit of Nephrology and Dialysis, Department of Medical Translational Sciences, University of Campania \u201cLuigi Vanvitelli\u201d, Naples, Italy"},{"name":"Biogem, Institute of Molecular Biology and Genetics, Ariano Irpino, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorenzo","family":"Di Liberato","sequence":"additional","affiliation":[{"name":"G. 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