由于糖尿病导致终末期肾病的患者中，CD28缺失和调节性T细胞受到严重破坏。
CD28null and Regulatory T Cells Are Substantially Disrupted in Patients with End-Stage Renal Disease Due to Diabetes Mellitus.
作者信息
Sampani Erasmia, Daikidou Dimitra-Vasilia, Lioulios George, Xochelli Aliki, Mitsoglou Zoi, Nikolaidou Vasiliki, Dimitriadis Chrysostomos, Fylaktou Asimina, Papagianni Aikaterini, Stangou Maria
机构信息
Department of Nephrology, Aristotle University of Thessaloniki, Hippokration Hospital, 56442 Thessaloniki, Greece.
National Peripheral Histocompatibility Center, Department of Immunology, Hippokration Hospital, 56442 Thessaloniki, Greece.
出版信息
Int J Mol Sci. 2021 Mar 15;22(6):2975. doi: 10.3390/ijms22062975.
BACKGROUND
End-stage renal disease (ESRD) is associated with alterations in T-cell immunity, including increased CD28null and reduced regulatory T cells (Tregs). However, whether immune disturbances are due to ESRD or primary disease is not yet clear. As diabetes mellitus is the leading cause of ESRD, we evaluated its impact on the immune profile of ESRD patients.
METHODS
CD28null, Tregs, and natural killer cells were initially analyzed by flow cytometry in 30 predialysis ESRD patients due to diabetes (DM), 30 non-DM (NDM), and 25 healthy controls. Measurements were repeated after 6 months on hemodialysis (HD) or peritoneal dialysis (CAPD).
RESULTS
The percentage of CD4 + CD28null cells, CD8 + CD28null cells, and Tregs showed significant differences in DM, NDM, and controls; mean rank 33.71 vs. 25.68 vs. 18.88, = 0.006, 37.79 vs. 28.82 vs. 17.08, = 0.008, and 20.79 vs. 26.12 vs. 41.33, = 0.001, respectively. DM vs. NDM had increased CD4 + CD28null and CD8 + CD28null cells, 11.5% (1.5%-24%) vs. 4.1% (0-42.3%), = 0.02 and 61.3% (24%-76%) vs. 43% (5.7%-85%), = 0.04, respectively. After 6 months on HD but not CAPD, DM showed a significant further increase in CD4 + CD28null cells, from 30 (14-100) to 52.7 (15-203), = 0.02; and CD8 + CD28null cells, from 137 (56-275) to 266 (103-456), = 0.01.
CONCLUSIONS
Diabetes mellitus affects T-cell subtypes even at predialysis stage, though changes become more prominent after commencement on HD.
背景
终末期肾病（ESRD）与T细胞免疫改变有关，包括CD28阴性细胞增加和调节性T细胞（Tregs）减少。然而，免疫紊乱是由ESRD还是原发性疾病引起尚不清楚。由于糖尿病是ESRD的主要原因，我们评估了其对ESRD患者免疫谱的影响。
方法
最初通过流式细胞术分析了30例因糖尿病（DM）导致的透析前ESRD患者、30例非糖尿病（NDM）患者和25例健康对照者的CD28阴性细胞、Tregs和自然杀伤细胞。在进行6个月的血液透析（HD）或腹膜透析（CAPD）后重复测量。
结果
DM组、NDM组和对照组的CD4 + CD28阴性细胞、CD8 + CD28阴性细胞和Tregs百分比存在显著差异；平均秩次分别为33.71对25.68对18.88，P = 0.006；37.79对28.82对17.08，P = 0.008；20.79对26.12对41.33，P = 0.001。DM组与NDM组相比，CD4 + CD28阴性细胞和CD8 + CD28阴性细胞增加，分别为11.5%（1.5%-24%）对4.1%（0-42.3%），P = 0.02；以及61.3%（24%-76%）对43%（5.7%-85%），P = 0.04。在进行6个月的HD而非CAPD后，DM组的CD4 + CD28阴性细胞显著进一步增加，从30（14-100）增至52.7（15-203），P = 0.02；CD8 + CD28阴性细胞从137（56-275）增至266（103-456），P = 0.01。
结论
糖尿病即使在透析前阶段也会影响T细胞亚型，不过在开始HD后变化更为显著。
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