Inflammation, T-Cell phenotype, and inflammatory cytokines in chronic kidney disease patients under hemodialysis and its relationship to resistance to recombinant human erythropoietin therapy

• Type: Article in International Scientific Journal
• Date: 2008

Authors

Elisio Costa (Author) FFUP; Margarida Lima (Author) ICBAS; Joao Moura Alves (Author) Other; Susana Rocha (Author) FFUP; Petronila Rocha Pereira (Author) Other; Elisabeth Castro (Author) Other; Vasco Miranda (Author) Other; Maria do Sameiro Faria (Author) Other; Alfredo Loureiro (Author) Other; Alexandre Quintanilha (Author) ICBAS; Luis Belo (Author) FFUP; Alice Santos Silva (Author) FFUP

Journal

Title: Journal of Clinical Immunology

Vol. 28 No. 3

Pages: 268-275

ISSN: 0271-9142

Publisher: Springer Nature

Indexing

ISI Web of Knowledge - 69 Citations

ISI Web of Science

Scopus - 72 Citations

Scientific classification

FOS: Medical and Health sciences > Basic medicine

Other information

Authenticus ID: P-003-ZR5

DOI: 10.1007/s10875-007-9168-x

Resumo (PT): Background Resistance to recombinant human erythropoietin (rhEPO) occurs in some chronic kidney disease (CKD) patients, which may be due to enhanced systemic inflammatory response and to the erythropoiesis-suppressing effect of pro-inflammatory cytokines, some of which are produced by T cells. Aim of study The aim of this study was to investigate the relationship between resistance to rhEPO therapy in hemodialysis CKD patients and inflammatory markers [Creactive protein (CRP), soluble interleukin (IL)-2 receptor (sIL2R), and serum albumin levels], blood cell counts, Tcell phenotype, cytokine production by T cells, and serum cytokine levels. Materials and Methods We studied 50 hemodialysis CKD patients, 25 responders and 25 nonresponders to rhEPO, and compared them to each other and with 25 healthy controls. When compared to controls, CKD patients showed increased serum levels of CRP, IL-6, and sIL2R and a T-cell lymphopenia, due to decreased numbers of both CD4+ and CD8+ T cells. T cells from CKD patients had an immunophenotype compatible with chronic T-cell stimulation as shown by the increased percentage of CD28−, CD57+, HLA-DR+, CD28−HLA-DR+, and CD57+ <br> <br> Keywords: rhEPO - Lymphocytes - Inflammation - Resistance to rhEPO therapy <br> <a target="_blank" href="http://www.springerlink.com/content/9282m41m1g176wv1/?p=5ac3220f0d174fb6aafbb85b0962b23e&pi=9"> Texto integral </a> <br> <br>

Abstract (EN): Background Resistance to recombinant human erythropoietin (rhEPO) occurs in some chronic kidney disease (CKD) patients, which may be due to enhanced systemic inflammatory response and to the erythropoiesis-suppressing effect of pro-inflammatory cytokines, some of which are produced by T cells. Aim of study The aim of this study was to investigate the relationship between resistance to rhEPO therapy in hemodialysis CKD patients and inflammatory markers [Creactive protein (CRP), soluble interleukin (IL)-2 receptor (sIL2R), and serum albumin levels], blood cell counts, T-cell phenotype, cytokine production by T cells, and serum cytokine levels. Materials and Methods We studied 50 hemodialysis CKD patients, 25 responders and 25 nonresponders to rhEPO, and compared them to each other and with 25 healthy controls. When compared to controls, CKD patients showed increased serum levels of CRP, IL-6, and sIL2R and a T-cell lymphopenia, due to decreased numbers of both CD4(+) and CD8(+) T cells. T cells from CKD patients had an immunophenotype compatible with chronic T-cell stimulation as shown by the increased percentage of CD28(-), CD57(+), HLA-DR(+), CD28(-)HLA-DR(+), and CD57(+) HLA-DR(+) T cells and produce higher levels of IL-2, INF-gamma, and TNF-alpha after short-term in vitro stimulation, although Th1 cytokines were not detectable in serum. Statistically significant differences were found between responders and nonresponders to rhEPO therapy for total lymphocyte and CD4(+) T-lymphocyte counts, albumin (lower in nonresponders) and CRP (higher in nonresponders) levels. Conclusion CKD patients under hemodialysis present with raised inflammatory markers and decrease of total lymphocyte and CD4+ T-lymphocyte counts when compared with controls. Some of those markers are even further enhanced in nonresponders to rhEPO therapy patients, but resistance to this therapy cannot be justified by a Th1 polarized T-cell response.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 8