Caprara Carlotta, Kinsey Gilbert R, Corradi Valentina, Xin Wenjun, Ma Jennie Z, Scalzotto Elisa, Martino Francesca K, Okusa Mark D, Nalesso Federico, Ferrari Fiorenza, Rosner Mitchell, Ronco Claudio
Blood Purif. 2016;42(4):307-313. doi: 10.1159/000449242. Epub 2016 Oct 1.
The study aimed to determine whether the available literature supports a positive or negative influence of dialysis on regulatory T-cells (Tregs).
We performed a systematic search and a meta-analysis. Mean differences in Tregs number of chronic kidney disease stages G5 on dialysis patients (CKD G5D) and healthy controls (HCs) were compared. Random effects model was applied. The software used was general package for meta-analysis (version 4.3-0, depends R (≥2.9.1)).
Five studies were included in the meta-analysis. The mean difference in percentage of Tregs on CD4+ T-cells between CKD G5D and HCs was not statistically different. Moreover, CKD GFR stages G5 not on dialysis (CKD G5) versus HC (p = 0.002; mean difference in Treg percentage was -2.47% in CKD G5 vs. HC) and CKD G5 versus CKD G5D (not significant).
This meta-analysis demonstrates an association between the uremic state and lower Tregs, and supports the hypothesis that hemodialysis alter Tregs. Our findings highlight the need for new clinical studies. Video Journal Club 'Cappuccino with Claudio Ronco' at http://www.karger.com/?doi=449242.
本研究旨在确定现有文献是否支持透析对调节性T细胞（Tregs）有正面或负面影响。
我们进行了系统检索和荟萃分析。比较了透析患者慢性肾脏病G5期（CKD G5D）和健康对照者（HCs）的Tregs细胞数量的平均差异。应用随机效应模型。使用的软件是荟萃分析通用软件包（版本4.3 - 0，依赖于R（≥2.9.1））。
五项研究纳入了荟萃分析。CKD G5D和HCs之间CD4 + T细胞上Tregs百分比的平均差异无统计学意义。此外，未透析的CKD GFR G5期（CKD G5）与HCs相比（p = 0.002；CKD G5与HCs相比Treg百分比的平均差异为 - 2.47%）以及CKD G5与CKD G5D相比（无显著性）。
这项荟萃分析表明尿毒症状态与较低的Tregs之间存在关联，并支持血液透析会改变Tregs的假说。我们的研究结果凸显了开展新的临床研究的必要性。视频期刊俱乐部“与克劳迪奥·龙科一起品尝卡布奇诺”，网址为http://www.karger.com/?doi=449242 。
