Impaired cellular immune responses in chronic renal failure: Evidence for a T cell defect

Abstract

Cellular immune responses in vitro were studied in 24 patients on chronic hemodialysis and 16 healthy volunteers with normal kidney function. Patients on maintenance hemodialysis had lymphopenia with diminished numbers of both T4+ and T8+ T-lymphocytes. The T4/T8 ratios were within the normal range. Peripheral blood lymphocytes (PBL) showed a diminished proliferative response upon stimulation with concanavalin A, phytohemagglutinin and pokeweed mitogen. When cell surface antigens were used for stimulation (mixed lymphocyte culture) uremic lymphocytes also showed a lower proliferation rate. Although without statistical conformation, there was a tendency by uremic PBL to produce less IL-2 as compared to healthy controls. Moreover, in a PWM driven system, peripheral blood lymphocytes from uremics produced significantly less IgG than PBL from normals. These results support the notion that a profound defect in lymphocyte function accounts at least, in part, for the observed immunodeficiency of uremic patients.

Herpes Labialis in Patients with Russell's Viper Bite and Acute Kidney Injury: A Single Center Experience

“…12 In critically ill patients with acute renal failure, initiation of continuous venovenous hemofiltration did not influence the CD3 and lymphocyte counts in both septic and non-septic acute renal failure. 13 Although this was just an observational study and our attempt was to highlight the fact that snake envenomation could be an immunosuppressed state, we realize that there were potential areas of uncertainty because of the lack of preexisting evidence.…”

Soluble CD40 in the serum of healthy donors, patients with chronic renal failure, haemodialysis and chronic ambulatory peritoneal dialysis (CAPD) patients

“…Some features of this cellular immunodeficiency are thought to result from a suppression of T helper cell type 1 (Th1) cytokines [9] and a defective costimulation of T cells via the B7-CD28 pathway [10]. Elevated circulating levels of cytokines and their corresponding receptors have been reported in the setting of chronic renal failure (CRF) [11][12][13][14][15][16][17], indicating that dysregulations in the cytokine network may be in part responsible for the development of uraemic immunodeficiency. In this study we investigated the in vivo presence of soluble CD40 and its possible changes in haemodialysis patients, CAPD patients and patients with CRF.…”

Selective blockade of the antigen-receptor-mediated pathway of T cell activation in patients with impaired primary immune responses.

“…Seroconversion occurred 12 mo after standard vaccination; anti-HBs positivity in two consecutive control patients (13,(16)(17)(18)(19)(20)(21)(22)(23)(24).…”