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尿毒症患儿外周血白细胞上免疫球蛋白G及补体受体的表达

IGG and complement receptor expression on peripheral white blood cells in uraemic children.

作者信息

Bouts Antonia H M, Krediet Raymond T, Davin Jean-Claude, Monnens Leo A H, Nauta Jeroen, Schröder Cornelis H, van de Winkel Jan G J, Out Theo A

机构信息

Emma Children's Hospital, G8-218, Academic Medical Center, PO Box 22700, 1100 DE, Amsterdam, the Netherlands.

出版信息

Nephrol Dial Transplant. 2004 Sep;19(9):2296-301. doi: 10.1093/ndt/gfh402. Epub 2004 Jul 20.

Abstract

BACKGROUND

Phagocytosis of IgG- or complement-opsonized bacteria and antibody production by lymphocytes are regulated by cell surface receptors for IgG (FcgammaRI, FcgammaRII and FcgammaRIII) and complement (CR1 and CR3). We measured the effect of uraemia and dialysis treatment on FcgammaR and CR expression on leukocytes in blood.

METHODS

Blood samples were obtained from children: 40 treated with peritoneal dialysis (PD), 23 with haemodialysis (HD), 46 not yet dialysed (CRF) and 33 healthy (HC). White blood cells, isolated from EDTA-blood by centrifugation after cell fixation with paraformaldehyde, were labelled with FITC-conjugated CD16 (FcgammaRIII), CD32 (FcgammaRII), CD64 (FcgammaRI), CD11b (CR3) and CD35 (CR1) monoclonal antibodies and analysed by flow cytometry.

RESULTS

In PD, HD, CRF and HC, monocytes and neutrophils were all positive for FcgammaR and CR, except for CD16 on monocytes (20% positive). Lymphocytes expressed CD16 and CD32 but not CD64. PD, HD and CRF children had lower percentages of CD16(+) and CD32(+) lymphocytes compared with HC. The percentage of CD11b(+) lymphocytes was lower only in PD and the percentage of CD35(+) lymphocytes was lower in HD and CRF compared with HC. The median CD32 mean fluorescense intensity (MFI) on lymphocytes, monocytes and neutrophils was lower in PD, HD and CRF compared with HC. On the other hand, CD11b MFI on lymphocytes, monocytes and neutrophils was higher in PD, HD and CRF children compared with HC. CD16 and CD64 MFI were not different among the groups and CD35 MFI was only lower on lymphocytes from PD, HD and CRF compared with HC.

CONCLUSIONS

In children with chronic renal failure, whether dialysed or not, FcgammaRII expression on lymphocytes, monocytes and neutrophils was reduced and CR3 expression was increased. Furthermore, CR1 expression on lymphocytes, important for the humoral response, was lower in children with renal failure. Age and uraemia are associated with these abnormalities and might contribute to impaired immune function in children with chronic renal failure.

摘要

背景

IgG或补体调理的细菌的吞噬作用以及淋巴细胞产生抗体的过程受IgG(FcγRI、FcγRII和FcγRIII)和补体(CR1和CR3)的细胞表面受体调节。我们测定了尿毒症和透析治疗对血液中白细胞上FcγR和CR表达的影响。

方法

采集儿童血液样本:40例接受腹膜透析(PD)治疗,23例接受血液透析(HD)治疗,46例尚未进行透析(CRF),33例健康儿童(HC)。用多聚甲醛固定细胞后通过离心从EDTA抗凝血中分离出白细胞,用异硫氰酸荧光素(FITC)偶联的CD16(FcγRIII)、CD32(FcγRII)、CD64(FcγRI)、CD11b(CR3)和CD35(CR1)单克隆抗体进行标记,并通过流式细胞术分析。

结果

在PD、HD、CRF和HC组中,单核细胞和中性粒细胞的FcγR和CR均呈阳性,但单核细胞上的CD16除外(20%呈阳性)。淋巴细胞表达CD16和CD32,但不表达CD64。与HC组相比,接受PD、HD治疗的儿童和CRF儿童中CD16(+)和CD32(+)淋巴细胞的百分比更低。仅在PD组中CD11b(+)淋巴细胞的百分比更低,与HC组相比,HD组和CRF组中CD35(+)淋巴细胞的百分比更低。与HC组相比,PD、HD和CRF组中淋巴细胞、单核细胞和中性粒细胞上CD32的平均荧光强度(MFI)中位数更低。另一方面,与HC组相比,PD、HD和CRF组儿童的淋巴细胞、单核细胞和中性粒细胞上CD11b的MFI更高。各组间CD16和CD64的MFI无差异,与HC组相比,仅PD、HD和CRF组淋巴细胞上CD35的MFI更低。

结论

在慢性肾衰竭儿童中,无论是否接受透析,淋巴细胞、单核细胞和中性粒细胞上FcγRII的表达均降低,CR3的表达增加。此外,对体液免疫反应很重要的淋巴细胞上CR1的表达在肾衰竭儿童中更低。年龄和尿毒症与这些异常有关,可能导致慢性肾衰竭儿童免疫功能受损。

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