Department of Internal Medicine, section Nephrology and Transplantation, Erasmus Medical Center, Rotterdam, the Netherlands.
Immun Ageing. 2012 Sep 12;9(1):19. doi: 10.1186/1742-4933-9-19.
End-stage renal disease (ESRD) patients treated with renal replacement therapy (RRT) have premature immunologically aged T cells which may underlie uremia-associated immune dysfunction. The aim of this study was to investigate whether uremia was able to induce premature ageing of the T cell compartment. For this purpose, we examined the degree of premature immunological T cell ageing by examining the T cell differentiation status, thymic output via T cell receptor excision circle (TREC) content and proliferative history via relative telomere length in ESRD patients not on RRT.
Compared to healthy controls, these patients already had a lower TREC content and an increased T cell differentiation accompanied by shorter telomeres. RRT was able to enhance CD8+ T cell differentiation and to reduce CD8+ T cell telomere length in young dialysis patients. An increased differentiation status of memory CD4+ T cells was also noted in young dialysis patients.
Based on these results we can conclude that uremia already causes premature immunological ageing of the T cell system and RRT further increases immunological ageing of the CD8+ T cell compartment in particular in young ESRD patients.
接受肾脏替代治疗 (RRT) 的终末期肾病 (ESRD) 患者的 T 细胞具有过早的免疫衰老，这可能是导致尿毒症相关免疫功能障碍的原因。本研究旨在探讨尿毒症是否能够诱导 T 细胞区室过早衰老。为此，我们通过检测 T 细胞受体切除环 (TREC) 含量来评估 T 细胞分化状态和胸腺输出，通过相对端粒长度来评估增殖史，从而检查了未接受 RRT 的 ESRD 患者的 T 细胞过早衰老的程度。
与健康对照组相比，这些患者的 TREC 含量较低，T 细胞分化增加，端粒较短。RRT 能够增强年轻透析患者的 CD8+T 细胞分化并降低 CD8+T 细胞端粒长度。年轻透析患者的记忆 CD4+T 细胞分化状态也有所增加。
基于这些结果，我们可以得出结论，尿毒症已经导致 T 细胞系统的过早免疫衰老，而 RRT 尤其在年轻 ESRD 患者中进一步增加 CD8+T 细胞区室的免疫衰老。
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