Research On T Lymphocyte Subsets And Its Costimulatory Molecules CD28As Well As Dendritic Cells In Patients With Chornic Kidney Disease

ObjectiveImmune function is abnormal in patients with chronic kidney disease. The mechanism of humoral immunity in the disease occurrence and development is widely studied and confirmed. However, the exact mechanism of cellular immunity disorder is uncertain. This study aims to investiage the possible cellular immunology mechanism in the process of chronic kidney disease by testing the number of T lymphocyte subsets, dendritic cells and CD28molecules from patients with chronic kidney disease, so as to provide theoretical basis for clinical immune therapy.MethodsPatients with chronic kidney disease(n=74) and normal contrls(n=22) were enrolled in the study, all patients were divided into four groups according to K/DOQI, that is CKD1and CKD2(A group), CKD3(B group), CKD4(C group), CKD5(D group). Serum creatinine(Scr), blood urea nitrogen(BUN), blood albumin(Alb) were detected by automatic biochemical analyzer, estimated glomerular filtration rate(eGFR) was calculated using MDRD. Cell percentages of T lymphocyte subset,CD28+cells and dendritic cells were analyzed by flow cytometer. One-way ANOVA was used to analyze the statistical difference by SPSS16.0.Results1. There was no significant difference in cell percentages of CD3+and CD3+CD8+among groups(P>0.05all); Compared with normal controls[median(IQR):34.3(32.60,43.78)%],cell percentages of CD3+CD4+from patients with CKD4and CKD5[44.81(41.01,45.68)%、43.40(40.28,47.05)%, P<0.01] was significantly increased; CD4/CD8ratio of patients with CKD5was significantly higher than normal controls[(2.13±0.84) vs.(1.53±0.54),P<0.05](mean±SD).2. Cell percentages of Thl in patients with CKD5[(12.71±3.55)%] was significantly higher than normal controls[(9.62±1.63)%,P<0.01].There was no significant difference in Th2among groups.Thl/Th2ratio was significantly lower in normal controls than patients with CKD3[(7.28±1.24) vs.(9.97±3.10), P<0.01] and CKD5[(12.01±5.10),P<0.01]. 3. There was no significant difference in cell percentages of CD28+and CD4+CD28+among groups. Cell percentage of CD8+CD28+was significantly higher in patients with CKD4than normal controls[(9.95±1.86)%vs.(6.73±3.14)%,P<0.05],while cell percentages of CD8+CD28+in patients with CKD5was significantly lowered than the other groups.4. Cell percentages of CD123+was significantly higher in normal controls than in patients with CKD4[(2.17±0.91)%vs.(1.43±0.24)%,P<0.05] and CKD5[(0.73±0.48)%,P<0.05],cell percentages of CD123+from patients with CKD5was significantly lower than the other CKD groups; Compared with normal controls, cell percentages of CD11c+was significantly decreased in patients with CKD.ConclusionsCellular immune function is disorder in patients with chronic kidney disease. With the development of disease, the imbalance and abnormal activation of T cell subsets is performed. Thl has the advantages of immune response in patients with chronic kidney disease. The imbalance between Thl and Th2destroys the stability of body environmet. The number of dendritic cells of peripheral blood is decreased with the development of disease. The immune effects produced by these immune cells change the pathothesis of kidney, all these cells take part in the occurrence and development of CKD. Further study on cellular immune mechanism will provide the theoretical basis for immune therapy.