Yoon J-W, Gollapudi S, Pahl M V, Vaziri N D
Division of Nephrology and Hypertension, Hallym University, Chunchon, Korea.
Kidney Int. 2006 Jul;70(2):371-6. doi: 10.1038/sj.ki.5001550. Epub 2006 May 31.
End-stage renal disease (ESRD) is associated with increased propensity to infections, diminished response to vaccination, impaired cell-mediated immunity, and reduced CD4+/CD8+ T-lymphocyte ratio. Four subsets of CD4+ and CD8+ T cells have been recently identified: naïve cells (as yet uncommitted), central memory (CM) cells (previously programmed), and CD45RA-positive and CD45RA-negative effector memory (EM) cells (programmed to perform specific effector functions). The effect of ESRD on subpopulations of T lymphocytes is unclear and was studied here. Twenty-one hemodialysis patients and 21 age-matched controls were studied. Pre- and post-dialysis blood samples were obtained and analyzed by three-color flow cytometry. CD4+/CD8+ ratio and the numbers of the naïve and CM CD4+ and CD8+ T cells were significantly reduced, whereas the numbers of EM CD4+ and CD8+ T cells were unchanged in the ESRD group. The reduction of the naïve and CM T-cell counts in the ESRD group was associated with increased apoptosis of these cells. Negative correlations were found between severity of azotemia, oxidative stress, and hyperphosphatemia with the number of naïve T cells. Comparison of diabetic with non-diabetic ESRD patients revealed higher numbers of total CD8+ cells and EM CD8+ T cells in the diabetic group. Dialysis did not significantly change the naïve and CM CD4+ or CD8+ cell counts, but significantly lowered CD8+ EM cell count. Thus, ESRD results in increased apoptosis and diminished populations of naïve and CM T lymphocytes. This phenomenon may, in part, contribute to the impaired immune response in this population.
终末期肾病（ESRD）与感染倾向增加、疫苗接种反应减弱、细胞介导免疫受损以及CD4+/CD8+ T淋巴细胞比例降低有关。最近已鉴定出CD4+和CD8+ T细胞的四个亚群：初始细胞（尚未定向分化）、中枢记忆（CM）细胞（先前已编程）以及CD45RA阳性和CD45RA阴性效应记忆（EM）细胞（已编程以执行特定效应功能）。ESRD对T淋巴细胞亚群的影响尚不清楚，本文对此进行了研究。研究了21例血液透析患者和21例年龄匹配的对照。采集透析前和透析后的血样，通过三色流式细胞术进行分析。ESRD组的CD4+/CD8+比值以及初始和CM CD4+和CD8+ T细胞数量显著降低，而EM CD4+和CD8+ T细胞数量未改变。ESRD组初始和CM T细胞计数的降低与这些细胞凋亡增加有关。氮质血症、氧化应激和高磷血症的严重程度与初始T细胞数量呈负相关。糖尿病ESRD患者与非糖尿病ESRD患者的比较显示，糖尿病组的总CD8+细胞和EM CD8+ T细胞数量更多。透析并未显著改变初始和CM CD4+或CD8+细胞计数，但显著降低了CD8+ EM细胞计数。因此，ESRD导致初始和CM T淋巴细胞凋亡增加且数量减少。这种现象可能部分导致了该人群免疫反应受损。
