The Eleventh People's Hospital of Chengdu, Chengdu 610000, P.R. China.
West China School of Public Health and Healthy Food Evaluation Center, Sichuan University, Chengdu 610041, P.R. China.
Biosci Rep. 2019 Oct 30;39(10). doi: 10.1042/BSR20191585.
Regulatory T (Treg) cells are of critical functionality in immune activation and inflammation in uremic patients undergoing hemodialysis (HD). A disruption in balance of Treg cells has potency to elicit infectious disease progression. Here, we examined possible association between ratio imbalance of Th22/Treg cells and microinflammation in uremic patients undergoing HD.
Peripheral blood mononuclear cells (PBMCs) were isolated to allow measurement of the percentage of Th22 cells and Treg cells using flow cytometry. Subsequently, serum levels of related cytokines, interleukin (IL) 22 (IL-22) and IL-10 and inflammatory factors, C-reactive protein (CRP), (TNF-α), IL-6 were determined via enzyme-linked immunosorbent assay (ELISA). Then relationships among dialysis time, microinflammation status (CRP) and dialysis adequacy (immunoreactive parathyroid hormone (iPTH), urea clearance index (Kt/V), β2-MG, serum calcium, and serum phosphorus) were evaluated. Finally, correlation between microinflammation status and dialysis adequacy was analyzed with Pearson's correlation coefficient.
An increased percentage of Th22 and a decreased percentage of Treg cells were evident in uremic patients undergoing HD. Serum levels of IL-22, CRP, TNF-α, and IL-6 were increased, while IL-10 serum level was reduced. An imbalance of Th22/Treg cells was associated with microinflammation status in uremic patients undergoing HD. Furthermore, prolongation of the dialysis time, the microinflammation status and dialysis adequacy were changed. Increased dialysis adequacy was observed to correlate with alleviated microinflammation of uremic patients undergoing HD.
Conjointly, an imbalance of Th22/Treg cells may be a potential cause responsible for uremia occurrence, which in turn indicates that uremia could be effectively alleviated by altering the ratio of Th22/Treg cells.
调节性 T（Treg）细胞在接受血液透析（HD）的尿毒症患者的免疫激活和炎症中具有关键功能。Treg 细胞平衡的破坏有可能引发感染性疾病的进展。在这里，我们研究了尿毒症患者 HD 中 Th22/Treg 细胞比例失衡与微炎症之间的可能关联。
分离外周血单核细胞（PBMC），使用流式细胞术测量 Th22 细胞和 Treg 细胞的百分比。随后，通过酶联免疫吸附试验（ELISA）测定相关细胞因子、白细胞介素（IL）22（IL-22）和 IL-10 以及炎症因子 C 反应蛋白（CRP）、（TNF-α）、IL-6 的血清水平。然后评估透析时间、微炎症状态（CRP）和透析充分性（免疫反应性甲状旁腺激素（iPTH）、尿素清除指数（Kt/V）、β2-MG、血清钙和血清磷）之间的关系。最后，用 Pearson 相关系数分析微炎症状态与透析充分性之间的相关性。
尿毒症患者 HD 中 Th22 细胞比例增加，Treg 细胞比例降低。IL-22、CRP、TNF-α 和 IL-6 血清水平升高，而 IL-10 血清水平降低。Th22/Treg 细胞失衡与尿毒症患者 HD 中的微炎症状态有关。此外，透析时间延长、微炎症状态和透析充分性发生变化。增加透析充分性与尿毒症患者 HD 中微炎症的减轻有关。
总之，Th22/Treg 细胞失衡可能是导致尿毒症发生的潜在原因，这反过来表明通过改变 Th22/Treg 细胞的比例可以有效缓解尿毒症。
