Immunologic Patterns in Hemodialysis Patients with and without HBV Infection

Abstract

66 patients from 5 dialysis centers were surveyed for the prevalence of HBV markers. Their immune status was evaluated by studying parameters of cellular and humoral immunity. Results showed that all patients had depressed T cell numbers while B cell counts, IgG, IgA, IgM, IgD and C₃ levels were normal. However, the group of patients who had persistent HBs antigenemia also had persistence of HBeAg, negative responsiveness to skin testing and high IgE levels. The group with HBsAb had negative reactions for skin testing, and the group with no HBV markers had no further abnormalities. These results suggest that the presence and type of HBV marker influences the immune pattern in the hemodialyzed patient.

Defective Radioresistant Suppressor Cell Activity in Hemodialysis Patients

“…Nevertheless, both assays are not entirely comparable because they are different in methodology, and, moreover, in their report DApiceet al [3], do not differentiate between radiosensi tive and radioresistant suppressor functions. The prob able monocyte defect suggested in our report is in agree ment with previous reports showing other alterations in monocyte function in HD patients, such as an enhanced attachment, spreading activity and impaired phagocyto sis of IgG-coated human erythrocytes [4]. It is wellknown that macrophages after being activated can in crease their spreading on glass and increase their content of lysosomal enzymes, but at the same time some other functions are decreased such as their antigen presenting properties [30].…”

“…The 'in vitro' analysis of the lymphocyte function demonstrates an alteration of cell-mediated immunity due to a diminished response to mitogenic challenge, and other abnormal cell-mediated reactions [1,2,4,[6][7][8]10]. This cell-mediated immunodeficiency has been attri buted to an increased suppressor function [6,[13][14][15] or to the expression of a 'pan-deficiency' in the PBL function [3,9], Investigators who postulate the active suppressor theory suggest that the monocyte could be responsible [6].…”

“…The mechanisms responsible for this rela tive anergy are unknown but uremic toxins and malnutri tion are the factors more commonly implicated [1][2][3]. Although several alterations of humoral immunity have been reported [1,2,4,5] the uremic immunodeficiency is mostly attributed to a deficiency of cell-mediated immu nity [1,[6][7][8]. Lymphopenia [2], reduced numbers of OKT 4 + cells [9], impaired cell-mediated immune reactions such as unresponsiveness to skin tests [2], prolonged skin graft survival [10], poor graft versus host reaction [4] and a low response to T-dependent mitogens [1,[6][7][8] are some of the alterations that have been described in these pa tients.…”

“…Although several alterations of humoral immunity have been reported [1,2,4,5] the uremic immunodeficiency is mostly attributed to a deficiency of cell-mediated immu nity [1,[6][7][8]. Lymphopenia [2], reduced numbers of OKT 4 + cells [9], impaired cell-mediated immune reactions such as unresponsiveness to skin tests [2], prolonged skin graft survival [10], poor graft versus host reaction [4] and a low response to T-dependent mitogens [1,[6][7][8] are some of the alterations that have been described in these pa tients. Normal reticuloendothelial clearance [1,11] and polymorphonuclear function [11] have also been re ported.…”

Cell-Mediated Immunity in Patients on Hemodialysis: Relationship with Hepatitis B Carrier Status

“…Hence, this depressed LPR probably contributed to the inability of patients on HD to clear HBV. In this regard, Samra et al [12] also found immunological differences between groups of HD patients who had persistent HBV antigenemia as compared with those who were HBs antibody positive. Although both groups showed negative delayed skin hypersensitivity responses, the group with HBs antigenemia also had an increase in serum IgE levels, sug gesting a loss in suppressor T cell activity.…”