Szydłowska I, Zukowska-Szczechowska E, Grzeszczak W
Katedra i Klinika Chorób Wewnetrznych i Diabetologii w Zabrzu Slaska Akademia Medyczna w Katowicach.
Pol Arch Med Wewn. 2000 Mar-Apr;103(3-4):169-77.
The hallmark of immunological memory is a quick and effective response to a repeated antigen exposure. Virgin lymphocytes, with their surface receptors CD45RA+, CD45RO- are produced in primary lymphatic organs, then migrating to secondary lymphatic structures. Memory lymphocytes CD45RO+, CD45RA- produced in these organs migrate to non-lymphatic organs--a possible location of inflammatory process, thus enabling the immunological system to eliminate effectively the same antigen, when repeatedly present. The aim of the study was 1) to test the influence of hemodialysis on the number of virgin lymphocytes and/or memory lymphocytes; 2) whether such impact (if any) depends on the type of dialysis membrane used (cuprophan or polysulphon), 3) if the effect is different in patients with or without diabetes. Overall number of virgin T helper lymphocytes CD45RA+CD4+ was significantly lower in patients with end-stage renal disease, while the number of total CD45RO+, CD45RA- memory lymphocytes was significantly greater among patients with diabetic nephropathy, compared to normal control subjects. After 15 minutes of hemodialysis, number of virgin lymphocytes CD45RA+, CD45RO- (p < 0.001, p < 0.01) and their subclasses, as well as memory lymphocytes CD45RO+, CD45RA- were significantly decreased. After 15 minutes of hemodialysis with polysulphon membrane, the decrease in T virgin cytotoxic, B virgin CD45RA+CD4-, T memory cytotoxic as well as B memory CD45RO+CD4- lymphocytes was significantly lower, when compared with cuprophan membrane (p < 0.02). Among patients treated with cuprophan hemodialysis, the decrease of T helper memory CD45RO+CD4+ lymphocytes was significantly lower in patients with diabetic nephropathy, than in non-diabetic patients.
In all patients with end-stage renal disease, the impact of hemodialysis on the number of memory lymphocytes CD45RO+, CD45RA-, as well as virgin lymphocytes CD45RA+, CD45RO- was shown, but the effect was less profound during hemodialysis with polysulphon membrane, compared to cuprophan. The presence of diabetic nephropathy effects the hemodialysis-induced changes in the number of T memory helper CD45RO+ CD45RO+CD4+ lymphocytes, with no impact on other subclasses of the examined cells.
免疫记忆的标志是对重复抗原暴露产生快速有效的反应。初始淋巴细胞及其表面受体CD45RA+、CD45RO-在初级淋巴器官中产生，然后迁移至次级淋巴结构。在这些器官中产生的记忆淋巴细胞CD45RO+、CD45RA-迁移至非淋巴器官——炎症过程可能发生的部位，从而使免疫系统在相同抗原再次出现时能够有效清除该抗原。本研究的目的是：1）测试血液透析对初始淋巴细胞和/或记忆淋巴细胞数量的影响；2）这种影响（如果有）是否取决于所用透析膜的类型（铜仿膜或聚砜膜）；3）在糖尿病患者和非糖尿病患者中这种影响是否不同。与正常对照受试者相比，终末期肾病患者中初始辅助性T淋巴细胞CD45RA+CD4+的总数显著降低，而糖尿病肾病患者中总CD45RO+、CD45RA-记忆淋巴细胞的数量显著增加。血液透析15分钟后，初始淋巴细胞CD45RA+、CD45RO-（p<0.001，p<0.01）及其亚类以及记忆淋巴细胞CD45RO+、CD45RA-的数量均显著减少。与铜仿膜相比，使用聚砜膜进行血液透析15分钟后，初始细胞毒性T细胞、初始B细胞CD45RA+CD4-、记忆细胞毒性T细胞以及记忆B细胞CD45RO+CD4-淋巴细胞的减少幅度显著更低（p<0.02）。在接受铜仿膜血液透析的患者中，糖尿病肾病患者辅助性记忆T细胞CD45RO+CD4+淋巴细胞的减少幅度显著低于非糖尿病患者。
在所有终末期肾病患者中，均显示出血液透析对记忆淋巴细胞CD45RO+、CD45RA-以及初始淋巴细胞CD45RA+、CD45RO-数量的影响，但与铜仿膜相比，使用聚砜膜进行血液透析时这种影响较小。糖尿病肾病的存在影响血液透析诱导的记忆辅助性T细胞CD45RO+CD45RO+CD4+淋巴细胞数量的变化，对所检测细胞的其他亚类无影响。
