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Immunological Alterations due to Hemodialysis Might Interfere with Early Complications in Renal Transplantation.
Analytical Cellular Pathology ( IF 2.6 ) Pub Date : 2019-03-25 , DOI: 10.1155/2019/8389765
Kristin Mai 1, 2 , Andreas Boldt 1 , Hans-Michael Hau 3 , Michael Kirschfink 4 , Stephan Schiekofer 5, 6 , Frieder Keller 7 , Joachim Beige 8, 9 , Athanassios Giannis 10 , Ulrich Sack 1 , Franz Maximilian Rasche 2
Affiliation  

Background. Chronic or intercurrent alterations of the immune system in patients with end-stage renal disease (CKD) and intermittent hemodialysis (CKD5D, HD) have been attributed to an acute rejection of renal allograft. Methods. Leukocyte subsets in flow cytometry, complement activation, and concentrations of TGFβ, sCD30 (ELISA), and interleukins (CBA) of fifteen patients eligible for renal transplantation were analyzed before, during, and after a regular HD. Results. Before HD, the median proportion of CD8+ effector cells, CD8+ CCR5+ effector cells, and HLA-DR+ regulatory T cells as well as the median concentration of soluble CD30 increased and naive CD8+ T cells decreased. During HD, there was a significant decrease in CD4- CD8- T cells () and an increase in CD25+ T cells (), sCD30 (), HLA-DR+ regulatory T cells (), and regulatory T cells (). TGFβ and sCD30 increased significantly over time. The activity of the classical complement pathway started to slightly increase after the first hour of HD and lasted until fifteen minutes after finishing dialysis. The decrease in the functional activity of the alternative pathway was only transient and was followed by a significant increase within 15 minutes after finishing the treatment. Conclusion. HD might interact with the allograft outcome by influencing T cell subsets and activation of the complement system in a biphasic course.

中文翻译:


血液透析引起的免疫改变可能会干扰肾移植的早期并发症。



背景。终末期肾病(CKD)和间歇性血液透析(CKD5D,HD)患者免疫系统的慢性或并发改变归因于同种异体移植肾的急性排斥。方法。在常规 HD 之前、期间和之后,对 15 名适合肾移植的患者的流式细胞术中的白细胞亚群、补体激活以及 TGF β 、sCD30 (ELISA) 和白细胞介素 (CBA) 浓度进行了分析。结果。 HD前,CD8+效应细胞、CD8+CCR5+效应细胞和HLA-DR+调节性T细胞的中位比例以及可溶性CD30的中位浓度增加,而初始CD8+T细胞减少。 HD 期间,CD4- CD8- T 细胞显着减少( 和 CD25+ T 细胞的增加( ), sCD30 ( )、 HLA-DR+ 调节性 T 细胞( 和调节性 T 细胞( )。 TGF β和 sCD30 随着时间的推移显着增加。经典补体途径的活性在 HD 的第一个小时后开始略有增加,并持续到透析结束后 15 分钟。 旁路途径功能活性的下降只是暂时的,随后在治疗结束后 15 分钟内显着增加。结论。 HD 可能通过影响双相过程中的 T 细胞亚群和补体系统的激活来与同种异体移植结果相互作用。
更新日期:2019-03-25
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