Department of Nephrology, 424 Military Hospital of Thessaloniki, 56429 Thessaloniki, Greece.
Department of Immunology, National Peripheral Histocompatibility Center, General Hospital Hippokration, 54642 Thessaloniki, Greece.
Int J Mol Sci. 2024 Oct 11;25(20):10925. doi: 10.3390/ijms252010925.
Senescence-resembling alterations on the lymphocytes of patients undergoing dialysis have been widely described. However, the pathophysiology behind these phenomena has not been clarified. In this study, we examined the impact of dialysis prescription on T and B lymphocytes, in patients undergoing dialysis.: T and B cell subsets were determined with flow cytometry in 36 patients undergoing hemodialysis and 26 patients undergoing hemodiafiltration, according to the expression of CD45RA, CCR7, CD31, CD28, CD57, and PD1 for T cells, and IgD and CD27 for B cells. The immune phenotype was associated with dialysis modality, hemofiltration volume, and mortality. Compared with hemodialysis, patients undergoing hemodiafiltration had a significantly decreased percentage of CD4+CD28-CD57- T cells [3.8 (2.4-5.3) vs. 2.1 (1.3-3.3)%, respectively, = 0.002] and exhausted CD4+ T cells [14.1 (8.9-19.4) vs. 8.5 (6.8-11.7)%, respectively, = 0.005]. Additionally, the hemofiltration volume was negatively correlated with CD8+ EMRA T cells (r = -0.46, = 0.03). Finally, the increased exhausted CD4+ T cell percentage was associated with increased all-cause mortality in patients undergoing dialysis, independent of age. Hemodiafiltration, especially with high hemofiltration volume, may have beneficial effects on senescence-related immune phenotypes. Immune phenotypes may also be a predicting factor for mortality in patients undergoing dialysis.
透析患者的淋巴细胞出现衰老样改变已被广泛描述。然而，这些现象背后的病理生理学尚未阐明。在这项研究中，我们检查了透析方案对透析患者 T 和 B 淋巴细胞的影响。：根据 T 细胞 CD45RA、CCR7、CD31、CD28、CD57 和 PD1 的表达以及 B 细胞 IgD 和 CD27 的表达，通过流式细胞术在 36 名血液透析患者和 26 名血液透析滤过患者中确定 T 和 B 细胞亚群。免疫表型与透析方式、血液滤过量和死亡率相关。与血液透析相比，血液透析滤过患者的 CD4+CD28-CD57- T 细胞百分比显著降低[分别为 3.8(2.4-5.3)和 2.1(1.3-3.3)%, = 0.002]和耗竭的 CD4+ T 细胞[分别为 14.1(8.9-19.4)和 8.5(6.8-11.7)%, = 0.005]。此外，血液滤过量与 CD8+ EMRA T 细胞呈负相关(r = -0.46, = 0.03)。最后，在透析患者中，耗竭的 CD4+ T 细胞百分比增加与全因死亡率增加独立相关，与年龄无关。血液透析滤过，特别是高血液滤过量，可能对与衰老相关的免疫表型有有益的影响。免疫表型也可能是透析患者死亡率的预测因素。
