血液透析引起的免疫改变可能会影响肾移植的早期并发症。

Immunological Alterations due to Hemodialysis Might Interfere with Early Complications in Renal Transplantation.

机构信息

Institute of Clinical Immunology, Medical Faculty, University of Leipzig, Leipzig, Germany.

Department of Internal Medicine, Neurology and Dermatology, Clinic for Endocrinology and Nephrology, Section of Nephrology, University Hospital Leipzig, Leipzig, Germany.

出版信息

Anal Cell Pathol (Amst). 2019 Mar 25;2019:8389765. doi: 10.1155/2019/8389765. eCollection 2019.

DOI:10.1155/2019/8389765

PMID:31019876

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6452532/

Abstract

BACKGROUND

Chronic or intercurrent alterations of the immune system in patients with end-stage renal disease (CKD) and intermittent hemodialysis (CKD5D, HD) have been attributed to an acute rejection of renal allograft.

METHODS

Leukocyte subsets in flow cytometry, complement activation, and concentrations of TGF, sCD30 (ELISA), and interleukins (CBA) of fifteen patients eligible for renal transplantation were analyzed before, during, and after a regular HD.

RESULTS

Before HD, the median proportion of CD8+ effector cells, CD8+ CCR5+ effector cells, and HLA-DR+ regulatory T cells as well as the median concentration of soluble CD30 increased and naive CD8+ T cells decreased. During HD, there was a significant decrease in CD4- CD8- T cells ( < 0.001) and an increase in CD25+ T cells ( = 0.026), sCD30 ( < 0.001), HLA-DR+ regulatory T cells ( = 0.005), and regulatory T cells ( = 0.003). TGF and sCD30 increased significantly over time. The activity of the classical complement pathway started to slightly increase after the first hour of HD and lasted until fifteen minutes after finishing dialysis. The decrease in the functional activity of the alternative pathway was only transient and was followed by a significant increase within 15 minutes after finishing the treatment.

CONCLUSION

HD might interact with the allograft outcome by influencing T cell subsets and activation of the complement system in a biphasic course.

摘要

背景

终末期肾病（CKD）和间歇性血液透析（CKD5D，HD）患者的免疫系统慢性或间歇性改变归因于肾移植的急性排斥反应。

方法

在常规 HD 前后，分析了 15 名适合肾移植患者的流式细胞术白细胞亚群、补体激活以及 TGF、sCD30（ELISA）和白细胞介素（CBA）浓度。

结果

在 HD 之前，CD8+效应细胞、CD8+CCR5+效应细胞和 HLA-DR+调节性 T 细胞的中位数比例以及可溶性 CD30 的中位数浓度增加，而幼稚 CD8+T 细胞减少。在 HD 期间，CD4-CD8-T 细胞显著减少（<0.001），CD25+T 细胞增加（=0.026），sCD30（<0.001），HLA-DR+调节性 T 细胞（=0.005）和调节性 T 细胞（=0.003）增加。TGF 和 sCD30 随时间显著增加。经典补体途径的活性在 HD 开始后第一个小时开始略有增加，并持续到透析结束后 15 分钟。替代途径的功能活性下降只是短暂的，在治疗结束后 15 分钟内会显著增加。