B cell-associated immune profiles in patients with end-stage renal disease (ESRD)

Abstract

Most of the previous studies on immune dysregulation in end-stage renal disease (ESRD) have focused on T cell immunity. We investigated B cell subpopulations in ESRD patients and the effect of hemodialysis (HD) on B cell-associated immune profiles in these patients. Forty-four ESRD [maintenance HD patients (n = 27) and pre-dialysis patients (n = 17)] and 27 healthy volunteers were included in this study. We determined the percentage of B cell subtypes, such as mature and immature B cells, memory B cells, and interleukin (IL)-10+ cells, as well as B cell-producing cytokines (IL-10, IL-4 and IL-21) by florescent activated cell sorting (FACS). B cell-associated gene expression was examined using real-time PCR and B cell producing cytokines (IL-10, IL-4 and IL-21) were determined using an enzyme-linked immunosorbent assay (ELISA). The percentage of total B cells and mature B cells did not differ significantly among the three groups. The percentages of memory B cells were significantly higher in the pre-dialysis group than in the HD group (P < 0.01), but the percentage of immature B cells was significantly lower in the pre-dialysis group than in the other groups. The percentages of IL-10-expressing cells that were CD19+ or immature B cells did not differ significantly (P > 0.05) between the two subgroups within the ESRD group, but the serum IL-10 concentration was significantly lower in the pre-dialysis group (P < 0.01). The results of this study demonstrate significantly altered B cell-associated immunity. Specifically, an imbalance of immature and memory B cells in ESRD patients was observed, with this finding predominating in pre-dialysis patients.

Lymphocyte depletion and subset alteration correlate to renal function in chronic kidney disease patients

“…25 A recent study also indicated a significant decrease in memory B cells in hemodialysis group; however, these cells were significantly higher in the pre-dialysis group compared to the hemodialysis group while immature B cells were significantly lower in the pre-dialysis group. 17 It suggested that there was defective regulatory activity in Figure 1. Association of NK cell proportion, B cell proportion, and eGFR.…”

“…12 Several studies indicated a reduction of peripheral blood T and B lymphocytes in patients with ESRD; however, the result remains controversial. [13][14][15][16][17][18][19] Of note, most of these studies on immune dysfunction have been restricted to ESRD patients. This is necessarily inadequate for the full understanding of impacts of CKD on immune system.…”

The Influence of Hemodialysis on T Regulatory Cells: A Meta-Analysis and Systematic Review

“…4 ). The studies included in this additional analysis are Lisowska et al [13] , Kim et al [22] and Zhang et al [23] . This analysis aimed to understand if the difference measured between CKD G5D patients and HCs is due to uremic state or hemodialysis treatments.…”

“…Five studies that included comparable HC and CKD G5D patients and used similar criteria for determining the percentage of Treg cells in total CD4 T-cells were subjected to a meta-analysis [13,[21][22][23][24] . The complete list of articles included in the systematic review is described in table 1 .…”

Prophylactic vaccinations in chronic kidney disease: Current status

“…18 Significantly altered B cell-associated immunity is a wellknown phenomenon related to GFR category 5 (end-stage renal disease, ESRD). 19 Pahl et al clearly showed that B-cell lymphopenia is associated with the downregulation of B-cell activating factor (BAFF) receptor in transitional B cells. This resulted in resistance to the biological actions of BAFF being a potent B-cell differentiation and survival factor.…”