Conversant Research Consorcium in Immunologic Disease, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Immunol Lett. 2012 Jan 30;141(2):181-9. doi: 10.1016/j.imlet.2011.10.002. Epub 2011 Oct 8.
Patients with end-stage renal disease (ESRD) exhibit immune dysregulation, but the precise immunological profile and the effect of hemodialysis (HD) on it has not been investigated fully. Thirty-eight ESRD patients (22 on HD and 16 in pre-dialysis) and 24 healthy volunteers were included. We compared the T cell immune profiles as in these patients. Among the effector T cell subset, the percentages of Th17 and Th2 cells were significantly higher in the ESRD group than in the healthy controls (P<0.05). The percentage of Th1 cells did not differ significantly between these groups. The percentages of Th1, Th2 and Th17 cells did not differ significantly (P>0.05) between the two subgroups within the ESRD group. The CCR4(-)CCR6(+)/CD4(+) T cell percentage was also significantly higher in the ESRD group. The naïve T cell (T(naïve)) percentage was significantly lower in the ESRD group, and the difference between patients and controls was greater in the pre-dialysis patients than in the HD patients (P<0.05, for each comparison). By contrast, the percentages of central memory T cells (T(CM)) and effector memory T (T(EM)) cells were significantly higher in the ESRD group. Interleukin-17 production by T(EM) cells was significantly higher in the ESRD group. The severity of uremia was related negatively to the T(naïve) cell percentage but positively to the T(CM) and T(EM) cell percentages. The percentages of T(EM) and CD45RA(+) T effector memory subsets of CD8(+) T cells were significantly higher in the ESRD group (P<0.05). The result of this study showed significantly altered T cell-associated immunity and that it could not be corrected with hemodialysis.
终末期肾病（ESRD）患者表现出免疫失调，但尚未充分研究其确切的免疫学特征和血液透析（HD）的影响。纳入 38 例 ESRD 患者（22 例接受 HD，16 例在透析前）和 24 名健康志愿者。我们比较了这些患者的 T 细胞免疫特征。在效应 T 细胞亚群中，ESRD 组 Th17 和 Th2 细胞的百分比明显高于健康对照组（P<0.05）。两组间 Th1 细胞的百分比无显著差异。ESRD 组内两个亚组间 Th1、Th2 和 Th17 细胞的百分比无显著差异（P>0.05）。ESRD 组 CCR4(-)CCR6(+)/CD4(+)T 细胞的百分比也明显更高。ESRD 组的幼稚 T 细胞（T(naïve)）百分比明显较低，且在透析前患者中与对照组的差异大于 HD 患者（P<0.05，每一次比较）。相反，中央记忆 T 细胞（T(CM)）和效应记忆 T（T(EM)）细胞的百分比在 ESRD 组明显较高。T(EM)细胞产生的白细胞介素-17 在 ESRD 组明显较高。尿毒症的严重程度与 T(naïve)细胞百分比呈负相关，与 T(CM)和 T(EM)细胞百分比呈正相关。ESRD 组 T(EM)和 CD45RA(+)T 效应记忆细胞亚群的 CD8(+)T 细胞百分比明显较高（P<0.05）。本研究结果显示 T 细胞相关免疫明显改变，血液透析无法纠正。
