Translational Immunology Laboratory, Health Research Institute of the Principality of Asturias, Hospital Universitario Central de Asturias, Oviedo, Spain.
Nephrology Service, Hospital Universitario Central de Asturias, Oviedo, Spain.
Front Immunol. 2019 Jul 19;10:1680. doi: 10.3389/fimmu.2019.01680. eCollection 2019.
Dialysis is the first procedure to partially replace renal function in end-stage renal diseases, despite several adverse side effects, such as infections. The primary aim of this study was to evaluate the levels of immune CMV-specific CD8+ T cells in a representative cohort of pre-transplant patients receiving hemodialysis (HD) or peritoneal dialysis (PD). The secondary aim was to monitor the CMV-specific CD8+ T cells in kidney transplant recipients undergoing different types of dialysis during the first year following their transplant. Sixty-nine patients were enrolled and examined with respect to the type of dialysis they received. HLA class I dextramers for CMV were used to determine the quantity of CMV-specific CD8+ T cells. The CMV DNA viral load was also determined. Forty-two of the patients enrolled in the study underwent solid organ transplantation and were analyzed during their first year post-transplantation. Patients receiving HD had fewer CMV-specific CD8+ T cells than those in PD ( < 0.05). We also observed that patients in PD had more CMV-specific CD8+ T cells during the follow-up period than those in HD ( < 0.05), independently of the CMV DNA. Finally, PD patients had a higher frequency of CD8+ Effector-Memory RA T cells (TEMRA) and a lower frequency of central memory T cells (TCM) than did HD patients. These results indicate the better status of CMV-specific T cell immunity in PD patients. The use of CMV T cell dextramers would be advantageous for monitoring the CD8+ T-specific response, enabling the use of prophylactic treatment to be optimized.
透析是终末期肾病患者部分替代肾功能的首选方法，但存在许多不良反应，如感染。本研究的主要目的是评估接受血液透析（HD）或腹膜透析（PD）的移植前患者代表性队列中免疫 CMV 特异性 CD8+T 细胞的水平。次要目的是监测接受不同类型透析的肾移植受者在移植后第一年 CMV 特异性 CD8+T 细胞。 69 名患者接受了他们接受的透析类型的检查。使用 HLA 类 I 手性二聚体来确定 CMV 特异性 CD8+T 细胞的数量。还确定了 CMV DNA 病毒载量。 42 名入组患者接受了实体器官移植，并在移植后第一年进行了分析。 接受 HD 的患者的 CMV 特异性 CD8+T 细胞比 PD 患者少（<0.05）。我们还观察到，PD 患者在随访期间的 CMV 特异性 CD8+T 细胞比 HD 患者多（<0.05），而与 CMV DNA 无关。最后，PD 患者的效应记忆 RA T 细胞（TEMRA）频率较高，中央记忆 T 细胞（TCM）频率较低，而 HD 患者则相反。 这些结果表明 PD 患者的 CMV 特异性 T 细胞免疫状态更好。使用 CMV T 细胞二聚体监测 CD8+T 细胞特异性反应将是有利的，从而能够优化预防性治疗的使用。
