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透析中运动对慢性肾脏病患者表达 CCR5+免疫细胞的影响:一项交叉试验。

The impact of intradialytic exercise on immune cells expressing CCR5+ in patients with chronic kidney disease: A cross-over trial.

机构信息

Research Center, Methodist University Center IPA, Porto Alegre, Rio Grande do Sul, Brazil.

Programa de Pós Graduação em Ciências Pneumológicas at Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil.

出版信息

Int J Artif Organs. 2022 Feb;45(2):221-226. doi: 10.1177/03913988211001388. Epub 2021 Mar 16.

Abstract

The C-C chemokine receptor type 5 (CCR5) plays a role in the immunopathogenesis of chronic kidney disease (CKD). Exercise has anti-inflammatory properties that may contribute to the rehabilitation of CKD patients. To date, the impact of the intradialytic exercise on CCR5 expression in monocytes and lymphocytes of CKD patients is unknown. We aimed to evaluate the effects of an acute intradialytic moderate-intensity exercise on CD4+CCR5+ T-cells and CD14+CCR5+ monocytes of elderly individuals with Chronic Kidney Disease (CKD). Eight CKD elderly patients performed a single bout of 20 min intradialytic exercise and a control hemodialysis (HD) session. Blood samples were collected at baseline, during and immediately after the trials. HD therapy increased the peripheral frequency of CD4+CCR5+ T-cells. The systemic CCL5 levels and the peripheral CD14+CCR5+ proportions increased during and after HD therapy. No significant alterations in CD4+CCR5+ and CD14+CCR5+ proportions or CCL5 levels were identified in CKD patients during and after intradialytic exercise. A negative correlation between the peripheral frequency of CD14+CCR5+ and the creatinine levels was identified in the intradialytic exercise session. A single moderate-intensity intradialytic exercise imposes an immunomodulatory impact in CKD elderly patients, preventing an excessive inflammatory response induced by hemodialysis.

摘要

C-C 趋化因子受体 5(CCR5)在慢性肾脏病(CKD)的免疫发病机制中起作用。运动具有抗炎特性,可能有助于 CKD 患者的康复。迄今为止,尚未了解透析期间运动对 CKD 患者单核细胞和淋巴细胞中 CCR5 表达的影响。我们旨在评估急性透析期间中等强度运动对老年慢性肾脏病(CKD)患者 CD4+CCR5+T 细胞和 CD14+CCR5+单核细胞的影响。8 名 CKD 老年患者进行了一次 20 分钟的透析期间中等强度运动和对照血液透析(HD)治疗。在基线、治疗期间和治疗后立即采集血液样本。HD 治疗增加了外周血 CD4+CCR5+T 细胞的频率。HD 治疗期间和治疗后,全身 CCL5 水平和外周 CD14+CCR5+比例增加。在透析期间和透析后,CKD 患者的 CD4+CCR5+和 CD14+CCR5+比例或 CCL5 水平没有明显变化。在透析期间运动中,外周 CD14+CCR5+的频率与肌酐水平之间存在负相关。单次中等强度透析期间运动对 CKD 老年患者产生免疫调节作用,可防止血液透析引起的过度炎症反应。

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