Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China; Shanghai Key Laboratory of Renal Disease and Blood Purification, Shanghai, China; Shanghai Medical Center of Kidney, Shanghai, China; Shanghai Institute of Kidney and Dialysis, Shanghai, China.
Department of Laboratory Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.
Clin Chim Acta. 2024 Mar 1;555:117791. doi: 10.1016/j.cca.2024.117791. Epub 2024 Jan 22.
T cell dysfunction observed in patients undergoing hemodialysis (HD) has been linked to an extremely high morbidity of cardiovascular events (CVEs) and infections. The cell-surface 5'-nucleotidase CD73 sets the balance between pro-inflammatory nucleotides and anti-inflammatory adenosine.
A total of 395 patients who had been receiving HD for at least six months were evaluated for proportions of CD73 cells in both the CD4 T cell and CD8 T cell compartment and followed for one year to document CVEs and infections. Differences in the proportions of CD73-expressingT cells between healthy controls and patients undergoing HD were compared. The relationship between CD73 T cells and clinical outcomes was analyzed using the Kaplan-Meier curve and Cox regression.
HD was significantly related to a lower fraction of CD4CD73 T cells. In patients on HD, lower proportions of CD4 CD73T cells and CD8 CD73T cells were both associated with systemic inflammation and T cell terminal differentiation. More importantly, a lower CD4CD73T cell ratio independently predicted CVEs and infection in these patients.
We identified CD73 as a T cell dysfunction marker predicting cardiovascular and infection events in patients undergoing HD, which provides a potential target in future studies of uremia-related immune dysfunction.
接受血液透析 (HD) 的患者中观察到的 T 细胞功能障碍与心血管事件 (CVE) 和感染极高的发病率有关。细胞膜表面的 5'-核苷酸酶 CD73 决定了促炎核苷酸和抗炎腺苷之间的平衡。
对至少接受 HD 治疗六个月的 395 名患者进行评估，以确定 CD4 T 细胞和 CD8 T 细胞区室中 CD73 细胞的比例，并随访一年以记录 CVE 和感染。比较健康对照组和接受 HD 治疗的患者中表达 CD73 的 T 细胞比例的差异。使用 Kaplan-Meier 曲线和 Cox 回归分析 CD73 T 细胞与临床结局的关系。
HD 与 CD4 CD73 T 细胞比例降低显著相关。在接受 HD 的患者中，CD4 CD73T 细胞和 CD8 CD73T 细胞的比例较低均与全身炎症和 T 细胞终末分化有关。更重要的是，较低的 CD4 CD73T 细胞比例独立预测了这些患者的 CVE 和感染。
我们将 CD73 鉴定为预测接受 HD 治疗的患者发生心血管和感染事件的 T 细胞功能障碍标志物，这为未来研究尿毒症相关免疫功能障碍提供了一个潜在的靶点。
