T cell subsets and cellular immunity in end-stage renal disease

Raska, K; Rašková, Jana; Shea, Stephen M.; Frankel, Richard M.; Wood, Robert H.; Lifter, John; Ghobrial, Ibrahim; Eisinger, Robert P.; Homer, Leroy

doi:10.1016/0002-9343(83)90401-1

Cited by 148 publications

(76 citation statements)

References 19 publications

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“…We found a striking decrease in levels of NKG2D expression in CD8 ϩ T cells as well as in NK cells. This could lead to impaired immune functions, consistent with previous studies showing an increased incidence of viral or bacterial infections (3,40) and of malignancies in these patients (41)(42)(43). The different subsets of NK cells did not show the same extent of reduction in NKG2D expression.…”

Section: Discussionsupporting

confidence: 87%

Oxidative Stress Mediates a Reduced Expression of the Activating Receptor NKG2D in NK Cells from End-Stage Renal Disease Patients

Péraldi

Berrou

Dulphy

et al. 2009

The Journal of Immunology

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To characterize the immune defect of patients with end-stage renal disease (ESRD), we performed NK cell subset analysis in 66 patients with ESRD treated by hemodialysis (n = 59) or peritoneal dialysis (n = 7). Compared with healthy blood donors, patients undergoing chronic dialysis showed a profound decrease in NKG2D+ cells within both the CD8+ T cell (58% vs 67%, p = 0.03) and NK cell (39% vs 56%, p = 0.002) populations. CD56dim cells, which comprise the majority of NK cells in the periphery, were more affected in this regard than were CD56bright cells. Uremic serum could decrease NKG2D expression on NK cells from healthy donors. Among factors that could contribute to the decrease in NKG2D expression in ESRD patients, reactive oxygen species (ROS) play a major role. We found that catalase could reverse the effects of uremic serum on NKG2D expression (p < 0.001) and that ROS down-regulated NKG2D at the mRNA level and at the NK cell surface. Additionally, ESRD patients had both increased membrane-bound MHC class I-related chain A (MICA) on monocytes (p = 0.04) and increased soluble MICA (203 pg/ml vs 110 pg/ml; p < 0.001). Both ROS and uremic serum could significantly increase in vitro the expression of the NKG2D ligand MICA on the renal epithelial cell line HK-2. Taken together, these studies suggest for the first time that both low NKG2D expression and up-regulation of its ligand MICA are related to ROS production and may be involved in the immune deficiency of ESRD patients.

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Section: Discussionsupporting

confidence: 87%

Oxidative Stress Mediates a Reduced Expression of the Activating Receptor NKG2D in NK Cells from End-Stage Renal Disease Patients

Péraldi

Berrou

Dulphy

et al. 2009

The Journal of Immunology

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“…As already reported by others (19,20), the relative proportions of helper/inducer (OKT4+) and cytotoxic/suppressor (OKT8+) T cells were found to be normal in these patients. However, in accordance with previous reports (15,16) and in line with the lymphocytopenia commonly observed in chronic uremia, significantly lower absolute counts of both regulatory lymphocyte subsets were observed as compared to normal controls.…”

Section: Discussionsupporting

confidence: 84%

Presence of preactivated T cells in hemodialyzed patients: their possible role in altered immunity.

Chatenoud¹,

Dugas²,

Beaurain³

et al. 1986

Proc. Natl. Acad. Sci. U.S.A.

109

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“…Infectious diseases rank first among non-CV causes of mortality in HD (13). Cell-mediated dysfunction related to decreased T cell number and impaired T cell proliferation is a key feature of early stage of chronic failure that persists during HD (15)(16)(17)43). Increased apoptosis as a result of uremia and enhanced by the HD procedure could be a major factor explaining T cell decrease (44,45).…”

Section: Discussionmentioning

confidence: 99%

“…An alteration of immune status mainly characterized by decreased T cell number and cell-mediated response contributes to enhancing susceptibility to infection of HD patients (15)(16)(17)(18). T helper (Th) lymphocytes have two subsets, Th1 that are involved in cell-mediated immunity and Th2 that are implied in humoral immune response.…”

mentioning

confidence: 99%

Fine-Tuning of the Prediction of Mortality in Hemodialysis Patients by Use of Cytokine Proteomic Determination

Badiou¹,

Cristol²,

Jaussent³

et al. 2008

Clinical Journal of the American Society of Nephrology

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Background and objectives: Inflammation-induced atherosclerosis and enhanced susceptibility to infection are linked to immune dysfunction and account for an important part of mortality in hemodialysis patients. This 4-yr prospective study aimed to use cytokine proteomic determination for predicting cardiovascular and noncardiovascular mortality in hemodialysis patients.Design, setting, participants, & measurements: Levels of 12 cytokines were measured using a proteomic biochip system in 134 patients who were on stable hemodialysis and compared with a control group of 150 healthy volunteers. Cox proportional hazards regression analysis was used to determine the relationship between cytokine and clinical outcome.Results: A proinflammatory state characterized by decreased anti-/proinflammatory cytokine ratio was evidenced in hemodialysis patients compared with control subjects. After adjustment for age, gender, smoking, and high-sensitivity C-reactive protein levels, IL-6 and (IL-4؉IL-10)/IL-6 ratio were associated with a significant and specific enhanced hazard ratio of cardiovascular mortality (hazard ratio 11.32 [95% confidence interval 2.52 to 50.90; P < 0.01] and hazard ratio 3.14 [95% confidence interval 1.20 to 8.22; P < 0.05], respectively, when comparing the third and first tertiles). It is interesting that (IL-4؉IL-6؉IL-10)/(IL-2؉IFN-␥) ratio, used as a marker of lymphocytes T helper subsets cytokine secretion, was associated only with noncardiovascular mortality (hazard ratio 4.93; 95% confidence interval 1.03 to 23.65; P < 0.05).Conclusion: Beyond the strong prediction of cardiovascular mortality by IL-6, determination of cytokine ratios can be useful to identify hemodialysis patients with increased noncardiovascular mortality risk.

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T cell subsets and cellular immunity in end-stage renal disease

Cited by 148 publications

References 19 publications

Oxidative Stress Mediates a Reduced Expression of the Activating Receptor NKG2D in NK Cells from End-Stage Renal Disease Patients

Oxidative Stress Mediates a Reduced Expression of the Activating Receptor NKG2D in NK Cells from End-Stage Renal Disease Patients

Presence of preactivated T cells in hemodialyzed patients: their possible role in altered immunity.

Fine-Tuning of the Prediction of Mortality in Hemodialysis Patients by Use of Cytokine Proteomic Determination

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