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尿毒症相关的T细胞过早衰老不能预测肾移植后的感染并发症。

Uremia-Associated Premature Aging of T Cells Does Not Predict Infectious Complications After Renal Transplantation.

作者信息

Dedeoglu B, Meijers R W J, Klepper M, Hesselink D A, Baan C C, Litjens N H R, Betjes M G H

机构信息

Department of Internal Medicine, Section Nephrology and Transplantation, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands.

出版信息

Am J Transplant. 2016 Aug;16(8):2324-33. doi: 10.1111/ajt.13759. Epub 2016 Mar 14.

Abstract

Patients with end-stage renal disease have prematurely aged T cell systems. We tested whether T cell aging parameters were associated with the risk of infections after renal transplantation (RTx). We studied 188 patients over 1 year. Peripheral T cells were analyzed before and at 3 and 6 mo after RTx for frequency of recent thymic emigrants, relative telomere length and differentiation status. These parameters were related to the occurrence of opportunistic and serious infections. Overall, 84 patients developed an infection. In this group, 50 developed an opportunistic infection and 53 developed a serious infection. T cell aging parameters assessed before RTx were not associated with infection risk. The memory T cells showed a decrease within the first 3 mo in both groups (p < 0.001). The CD4(+) memory T cells increased between 3 and 6 mo within the infection group (p = 0.015). The number of CD8(+) memory T cells increased in both groups (p < 0.001) but reached baseline levels only in the infection group. In the infection group, the CD8(+) CD28(null) T cell percentage increased between 3 and 6 mo (p = 0.024), tending to be higher than at baseline (p = 0.061). These differences in post-RTx dynamics resulted from infections. Parameters of uremia-associated premature aging of peripheral T cells do not predict posttransplant infections.

摘要

终末期肾病患者的T细胞系统过早老化。我们测试了T细胞老化参数是否与肾移植(RTx)后感染风险相关。我们对188名患者进行了为期1年的研究。在RTx前以及RTx后3个月和6个月时分析外周血T细胞,以检测近期胸腺迁出细胞的频率、相对端粒长度和分化状态。这些参数与机会性感染和严重感染的发生有关。总体而言,84名患者发生了感染。在该组中,50名患者发生了机会性感染,53名患者发生了严重感染。RTx前评估的T细胞老化参数与感染风险无关。两组的记忆T细胞在最初3个月内均减少(p<0.001)。感染组的CD4(+)记忆T细胞在3至6个月之间增加(p = 0.015)。两组的CD8(+)记忆T细胞数量均增加(p<0.001),但仅在感染组达到基线水平。在感染组中,CD8(+)CD28(null)T细胞百分比在3至6个月之间增加(p = 0.024),趋于高于基线水平(p = 0.061)。RTx后动力学的这些差异是由感染引起的。外周血T细胞与尿毒症相关的过早老化参数不能预测移植后感染。

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