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Increased expression of CD25 and HLA-DR on lymphocytes recruited into the peritoneal cavity in non-infected CAPD
A Brauner1, B Hylander, S H Jacobson
1Department of Clinical Microbiology and MTC, Karolinska Hospital, Karolinska Institute, Stockholm, Sweden.
Insights
Uremia and dialysis treatments reduce lymphocyte counts. However, lymphocytes in peritoneal dialysis fluid show signs of activation, potentially explaining infection susceptibility in patients undergoing dialysis.
Area of Science:
- Immunology
- Nephrology
- Clinical Medicine
Background:
- Uremia and dialysis treatments can impact immune function.
- Understanding lymphocyte alterations is crucial for managing infections in kidney disease patients.
Purpose of the Study:
- To evaluate the impact of uremia, peritoneal dialysis (PD), and hemodialysis (HD) on lymphocyte characteristics.
- To compare lymphocyte profiles in peripheral blood and peritoneal dialysate.
Main Methods:
- Flow cytometry was used to analyze CD4, CD8, CD25, and HLA-DR markers on lymphocytes.
- Samples were obtained from peripheral blood of uremic, HD, and CAPD patients, and from CAPD dialysate.
Main Results:
- Reduced lymphocyte counts were observed in the peripheral blood of uremic, HD, and CAPD patients compared to controls.
- Lymphocytes in peritoneal dialysate showed a higher relative distribution and increased activation markers (CD25, HLA-DR) compared to peripheral blood.
- Absolute CD4 counts were lower in the peripheral blood of all patient groups.
Conclusions:
- Dialysis treatments and uremia lead to decreased peripheral lymphocyte counts.
- Selective lymphocyte activation occurs within the peritoneal dialysate, suggesting localized immune responses.
- Altered lymphocyte function may contribute to increased infection risk in dialysis patients.
Abstract:
The impact of uremia per se, peritoneal dialysis (PD) and hemodialysis (HD) treatment was evaluated on characteristics of lymphocytes. CD4, CD8, CD25 and HLA-DR were analyzed, with flow cytometry, in lymphocytes prepared from peripheral blood of uremic (n = 10) and hemodialysis patients (n = 10). Peritoneal dialysate was also obtained from patients on CAPD (n = 12). A decreased relative and absolute lymphocyte count was observed in peripheral blood from uremic, HD and CAPD patients compared to healthy controls (p < 0.03, p < 0.03 and p < 0.02, respectively). On the other hand, the relative distribution of lymphocytes was significantly higher in peritoneal dialysate compared to peripheral blood of CAPD patients (p < 0.02). Likewise, the absolute CD4 positive lymphocyte count was lower in the peripheral blood from uremic. HD and CAPD patients as compared to healthy controls (p < 0.001, respectively). In CAPD patients the relative distribution of CD4 positive cells (p < 0.001) was lower, while quantitative CD25 level (p < 0.01) and the relative count of HLA-DR (p < 0.0001) was increased in the peritoneal dialysate compared to blood. Taken together a selective activation of lymphocytes in peritoneal dialysate as compared to peripheral blood from uremic, HD and CAPD patients was observed. The altered biological function of the inflammatory cells may therefore explain the increased susceptibility to infectious diseases.
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