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Altered monocyte function in uremia
R A Gibbons1, O M Martinez, M R Garovoy
1Immunogenetics and Transplantation Laboratory, Department of Surgery, University of California, San Francisco 94143.
Clinical Immunology and Immunopathology
|July 1, 1990
Summary
Uremia impairs immune cells, particularly monocytes, hindering their ability to stimulate T cells. This defect in monocyte accessory cell function contributes to the increased infection risk in uremic patients.
Area of Science:
- Immunology
- Nephrology
- Cell Biology
Background:
- Uremia is associated with immune suppression and increased susceptibility to infections.
- Cellular immunity defects are observed in patients with uremia.
- Mononuclear cells (MNC) from uremic patients show reduced responsiveness to antigens in vitro.
Purpose of the Study:
- To investigate the defect in cellular immunity in uremic patients.
- To determine the role of monocytes and T cells in the impaired immune response of uremia.
- To elucidate the function of monocytes as accessory cells in uremic patients.
Main Methods:
- Exposing MNC from uremic patients and controls to various antigens (tetanus toxoid, diphtheria toxoid, Candida albicans antigen) in vitro.
- Isolating monocytes and T cells from MNC of uremic patients and HLA class II matched controls.
- Incubating tetanus toxoid-pulsed uremic monocytes with control T lymphocytes and vice versa.
- Analyzing the proliferative response of T lymphocytes.
Main Results:
- Uremic MNC exhibited significantly lower responsiveness to antigens compared to controls.
- Tetanus toxoid-pulsed uremic monocytes failed to stimulate proliferation in HLA-identical control T lymphocytes.
- T lymphocytes from uremic patients could be stimulated by tetanus toxoid-pulsed control monocytes.
- Uremic monocytes displayed normal FcR expression, IL-1 beta production, and HLA class II antigen levels.
Conclusions:
- Uremia severely impairs the accessory cell function of monocytes.
- The defect in monocyte accessory function is a key factor in the immunological abnormalities observed in uremia.
- The precise biochemical defect in uremic monocytes requires further investigation but likely explains immune dysfunction and infection risk.
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