Department of Internal Medicine, Clinical Immunology and Allergy, Faculty of Medicine, Ain Shams University, Egypt.
Department of Internal Medicine and Nephrology, Theodor Bilharz Research Institute, Egypt.
Hum Immunol. 2019 Sep;80(9):748-754. doi: 10.1016/j.humimm.2019.03.008. Epub 2019 Mar 7.
End-stage renal disease (ESRD) patients, including those on hemodialysis, possess a high risk for cardiovascular diseases, as the first leading cause of death among them. Traditional risk factors do not utterly elucidate this. Throughout the last two decades, CD4CD28 T cells; an unusual subset of T lymphocytes, was detected high with excess cardiovascular (CV) mortality. We aimed to investigate the circulating CD4CD28 T cells frequency in ESRD patients on hemodialysis and to evaluate their relationship with atherosclerotic changes. High-resolution carotid ultrasonography was done to assess the common carotid artery intima media thickness in a number of ESRD patients, accordingly patients were selected and subdivided into two groups; 30 with atherosclerosis (mean [SD] age, 51.6 [6.3] years) and 30 without (mean [SD] age, 48.9 [5.5] years). Another 30 healthy individuals (mean [SD] age, 48.5 [6.8] years) were enrolled. Analysis of CD4CD28 T-cells frequency by flow-cytometry was performed in all studied subjects. CD4CD28 T cell percentage was significantly higher in ESRD patients, (mean [SD], 7.3 [2.7] %) compared to healthy individuals (mean [SD], 3.0 [0.8] %), (p < 0.001). Additionally, the expansion of these unusual T lymphocytes was significantly higher in ESRD patients with atherosclerotic changes (mean [SD], 9.47 [0.75] %) compared to those without atherosclerosis (mean [SD], 5.22 [2.14] %), (p < 0.001). In conclusion circulating CD4CD28 T lymphocyte population showed expansion in ESRD patients, and of interest in correlation to preclinical atherosclerotic changes.
终末期肾病（ESRD）患者，包括血液透析患者，心血管疾病风险较高，是其首要死亡原因。传统危险因素并不能完全解释这一点。在过去的二十年中，CD4CD28 T 细胞；一种异常的 T 淋巴细胞亚群，被发现与心血管（CV）死亡率过高有关。我们旨在研究血液透析的 ESRD 患者循环 CD4CD28 T 细胞的频率，并评估其与动脉粥样硬化变化的关系。对大量 ESRD 患者进行高分辨率颈动脉超声检查，以评估颈总动脉内膜中层厚度，随后选择患者并分为两组；30 例有动脉粥样硬化（平均[标准差]年龄，51.6[6.3]岁）和 30 例无动脉粥样硬化（平均[标准差]年龄，48.9[5.5]岁）。另外 30 名健康个体（平均[标准差]年龄，48.5[6.8]岁）被纳入研究。对所有研究对象进行流式细胞术分析 CD4CD28 T 细胞频率。ESRD 患者的 CD4CD28 T 细胞百分比（平均[标准差]，7.3[2.7]%）明显高于健康个体（平均[标准差]，3.0[0.8]%）（p<0.001）。此外，在有动脉粥样硬化变化的 ESRD 患者中，这些异常 T 淋巴细胞的扩增明显更高（平均[标准差]，9.47[0.75]%）与无动脉粥样硬化的患者相比（平均[标准差]，5.22[2.14]%）（p<0.001）。总之，循环 CD4CD28 T 淋巴细胞群体在 ESRD 患者中表现出扩张，并且与临床前动脉粥样硬化变化相关。
