Department of Nephrology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Nephrol Dial Transplant. 2011 May;26(5):1689-94. doi: 10.1093/ndt/gfr010. Epub 2011 Mar 7.
End-stage renal failure patients, including those on peritoneal dialysis (PD), exhibit several nontraditional cardiovascular (CV) risk factors. A role of CD4(+)CD28(null) T lymphocytes in the genesis of coronary artery disease (CAD) has been proposed. We investigated this cell population and examined its phenotype in a cohort of PD patients without CV disease.
The frequency of the peripheral blood CD4(+)CD28(null) T-cell compartment and cytotoxic characteristic of these cells (as assessed by perforin and granzyme B expressions) were determined in 33 PD patients without CAD and 20 healthy subjects by two- and three-color flowcytometry. High-sensitivity C-reactive protein (hs-CRP) was determined by enzyme-linked immunosorbent assay. We investigated whether there was a correlation between these cells and traditional CV risk factors.
Compared to healthy controls, CD4(+)CD28(null) T cells were significantly expanded in PD patients (10.30 ± 2.03% versus 3.55 ± 0.67%, mean ± SE, P = 0.0007). Perforin and granzyme B expressions were restricted to CD4(+)CD28(null) T cells compared to CD4(+)CD28(+) T cells (<0.0001). A greater proportion of CD4(+)CD28(null) T cells in PD patients expressed these molecules (P = 0.007 and 0.04). hs-CRP level was increased in PD patients (P < 0.0001) but did not correlate with the CD4(+)CD28(null) T-cell frequency. Increasing age correlated with the CD4(+)CD28(null) cells.
PD patients exhibit a substantially increased number of circulating CD4(+)CD28(null) T cells that show a cytolytic profile before the onset of clinically significant CAD. Their significance as a nontraditional CV risk factor needs further studies.
终末期肾衰竭患者，包括腹膜透析（PD）患者，表现出多种非传统心血管（CV）危险因素。已经提出 CD4+CD28（null）T 淋巴细胞在冠状动脉疾病（CAD）发病机制中的作用。我们调查了这一群细胞，并在没有 CV 疾病的 PD 患者队列中检查了其表型。
通过双色和三色流式细胞术，在 33 名无 CAD 的 PD 患者和 20 名健康对照者中，测定外周血 CD4+CD28（null）T 细胞区室的频率和这些细胞的细胞毒性特征（通过穿孔素和颗粒酶 B 表达评估）。通过酶联免疫吸附试验测定高敏 C 反应蛋白（hs-CRP）。我们研究了这些细胞与传统 CV 危险因素之间是否存在相关性。
与健康对照组相比，PD 患者的 CD4+CD28（null）T 细胞明显扩增（10.30 ± 2.03%对 3.55 ± 0.67%，均值 ± SE，P = 0.0007）。与 CD4+CD28（+）T 细胞相比，穿孔素和颗粒酶 B 的表达仅限于 CD4+CD28（null）T 细胞（<0.0001）。PD 患者中表达这些分子的 CD4+CD28（null）T 细胞比例更高（P = 0.007 和 0.04）。PD 患者 hs-CRP 水平升高（P<0.0001），但与 CD4+CD28（null）T 细胞频率无关。年龄增加与 CD4+CD28（null）细胞相关。
PD 患者表现出循环 CD4+CD28（null）T 细胞数量显著增加，这些细胞在出现临床显著 CAD 之前表现出细胞毒性特征。它们作为非传统 CV 危险因素的意义需要进一步研究。
