Treg/Th17 Functional Disequilibrium in Chinese Uremia on Hemodialysis: A Link between Calcification and Cardiovascular Disease

Chen, Danyan; Huang, Xiaolong; Yang, Ming; Gan, Hua; Gunawan, Evan Jim; Tang, Weixue

doi:10.3109/0886022x.2012.672155

Cited by 13 publications

(13 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This could be due to small differences in cell number (Treg and CD4+) and the lower number of patients, or it could be that the percentage of Tregs/CD4+ does not change with dialysis, but the total number of both Tregs and total CD4+ T-cells is reduced by dialysis. The paper of Chen et al [26] showing a dramatic increase in the frequency of Tregs in CKD G5D patients in comparison to HCs deserves a special comment. In the study, the frequency of Treg cells reported in CKD G5D patients (5.92 and 4.46%) are in the expected range, while they show very small frequency of Treg in HCs; so it appears from their manuscript that there is an approximately 15-fold increase in the frequency of Treg cells in CKD G5D patients that seems highly unlikely given the much lower magnitude of changes reported in each of the other studies.…”

Section: Discussionmentioning

confidence: 99%

“…This idea is supported by all other articles included in the systematic review that analyze Treg absolute number, adding strong support to the hypothesis that hemodialysis treatments are responsible for lowering not only CD4+ T-cells in general, but also Treg cells [6] . With one exception (Chen et al [26] ), Treg are thought to be lower in CKD G5D subjects. Hendrikx et al [6] , Baron et al [19] and Topal et al [20] evaluated absolute number of Treg (in CKD G5D subjects) and have showed that Treg absolute number is lower in these patients in comparison to HC.…”

Section: Discussionmentioning

confidence: 99%

“…Ten studies fulfilled the inclusion criteria and are part of the systematic review; 5 articles are excluded from the meta-analysis: 4 articles do not report numerical data that are only described and discussed, making impossible their inclusion in the statistical analysis [6,19,20] and 1 manuscript had imprecision in the materials and methods section such that it is not possible to understand how they count Treg cells [26]. 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] .…”

Section: Study Characteristics and Selectionmentioning

confidence: 99%

See 2 more Smart Citations

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

Caprara

Kinsey²,

Corradi

et al. 2016

Blood Purif

View full text Add to dashboard Cite

Aims: The study aimed to determine whether the available literature supports a positive or negative influence of dialysis on regulatory T-cells (Tregs). Methods: We performed a systematic search and a meta-analysis. Mean differences in Tregs number of chronic kidney disease stages G5 on dialysis patients (CKD G5D) and healthy controls (HCs) were compared. Random effects model was applied. The software used was general package for meta-analysis (version 4.3-0, depends R (≥2.9.1)). Results: Five studies were included in the meta-analysis. The mean difference in percentage of Tregs on CD4+ T-cells between CKD G5D and HCs was not statistically different. Moreover, CKD GFR stages G5 not on dialysis (CKD G5) versus HC (p = 0.002; mean difference in Treg percentage was -2.47% in CKD G5 vs. HC) and CKD G5 versus CKD G5D (not significant). Conclusion: This meta-analysis demonstrates an association between the uremic state and lower Tregs, and supports the hypothesis that hemodialysis alter Tregs. Our findings highlight the need for new clinical studies. Video Journal Club ‘Cappuccino with Claudio Ronco' at http://www.karger.com/?doi=449242.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Study Characteristics and Selectionmentioning

confidence: 99%

See 1 more Smart Citation

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

Caprara

Kinsey²,

Corradi

et al. 2016

Blood Purif

View full text Add to dashboard Cite

show abstract

“…To demonstrate whether Treg/Th17 is associated with cardiovascular disease in uremic patients during MHD, we detected Treg/Th17 functions on different levels including cell frequencies, related cytokine secretion and key costimulatory molecules. It is noteworthy that the Treg/Th17 cell function disequilibrium might act synergistically with calcification in the high incidence of cardiovascular disease subsequent to hemodialysis, which has been indirectly demonstrated in a previous study with the aid of ex vivo intervention of recombinant human bone morphogenetic protein-2 (13). However, the previous study was completely based on hemodialysis patients, who did not have uremia or were not assessed for baseline cardiovascular disease.…”

Section: Discussionmentioning

confidence: 69%

Treg/Th17 imbalance is associated with cardiovascular complications in uremic patients undergoing maintenance hemodialysis

et al. 2013

Self Cite

View full text Add to dashboard Cite

Abstract.Investigations of Treg/Th17 imbalance associated with cardiovascular complications in hemodialysis are limited. The aim of this study was to examine the association between Treg/Th17 balance and cardiovascular comorbidity in maintenance hemodialysis (MHD). Uremic patients included in the present study were divided into three groups: the WHD group comprising 30 patients with no cardiovascular complications or maintenance hemodialysis (MHD), the MHD1 group comprising 36 patients presenting with cardiovascular complications during MHD, and the MHD2 group comprising 30 patients with a lack of cardiovascular complications during MHD. The control group comprised 20 healthy volunteers. Th17 and Treg cells were measured by fluorescence-activated cell scanning (FACS). IL-6 and IL-10 levels were determined by enzyme-linked immunosorbent assay (ELISA). Monocyte surface expression of the costimulatory molecules CD80 and CD86 was assessed by FACS after the monocytes were cocultured with Th17 or Treg cells in the presence or absence of IL-17. Results revealed that the percentage of Th17 of total CD4(+) cells was significantly higher in the MHD1 (36.27±9.62% in) and WHD (35.98±8.85%) groups compared with the MHD2 (19.64±5.97%) and healthy (1.12±1.52%) groups. Elevated IL-6 levels were obtained in Th17 cells for the MHD1 and WHD groups, whereas a marked decrease was evident when IL-17 was blocked. However, no significant differences or cardiovascular complications were detected in the expression of CD80 and CD86 in the MHD group, whereas the expression of the uremic subgroups was statistically higher compared with the healthy controls. To the best of our knowledge, this is the first study to demonstrate that the Treg/Th17 imbalance may be associated with the pathogenesis of cardiovascular complications in uremic patients undergoing hemodialysis through the B7-independent upregulation of IL-6 induced by IL-17.

show abstract

“…Our previous study indicated that levels of Th-17 cells are increased and levels of Treg cells decreased in chronic hemodialysis (HD) patients (Lang CL et al, [33] 2013 in press). The functional imbalance of Th-17/Treg in uremic patients has been associated with the development of acute cardiovascular events, myocardial injury, and microinflammation [35,36]. In most CKD with type 2 diabetes patients, lots of circulating cytokines and acute phase proteins provides the immune dysfunction.…”

Section: Immune Dysregulation In Ckd Patientsmentioning

confidence: 99%

A Review of Chronic Kidney Disease and the Immune System: A Special Form of Immunosenescence

Hsu¹,

Lang²,

Wang³

et al. 2014

J Gerontol Geriatric Res

View full text Add to dashboard Cite

Immune dysregulation is a common problem and immunosenescence plays a major role in the aged population. Many chronic inflammatory diseases have the same effect in the aged such as chronic HIV-treated patients, tuberculosis patients or those with chronic kidney disease. Chronic kidney disease patients have a high incidence of vascular calcification, accelerated atherosclerosis, loss of appetite, increased muscle catabolism, renal osteodystrophy, and a high prevalence of depression because of the dysregulation of the immune system. These patients have different immune system manifestations compared with aged individuals of the same age; moreover, many geriatric syndromes are observed in this group. This review is an analysis from the nephrology perspective on the relationship between chronic kidney disease and the immune system.

show abstract

Treg/Th17 Functional Disequilibrium in Chinese Uremia on Hemodialysis: A Link between Calcification and Cardiovascular Disease

Cited by 13 publications

References 22 publications

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

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

Treg/Th17 imbalance is associated with cardiovascular complications in uremic patients undergoing maintenance hemodialysis

A Review of Chronic Kidney Disease and the Immune System: A Special Form of Immunosenescence

Contact Info

Product

Resources

About