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Expanded peripheral CD4+CD28null T cells and its association with atherosclerotic changes in patients with end stage

Ashraf Mahmoud Okba1, Mannar Abd El Raouf Raafat2, Mohamed Nazmy Farres1

  • 1Department of Internal Medicine, Clinical Immunology and Allergy, Faculty of Medicine, Ain Shams University, Egypt.

Human Immunology
|March 12, 2019
PubMed

Insights

Patients with end-stage renal disease (ESRD) have higher levels of CD4+CD28null T cells, a risk factor for cardiovascular disease. These cells are also linked to atherosclerosis in ESRD patients on hemodialysis.

Area of Science:

  • Immunology
  • Nephrology
  • Cardiology

Background:

  • End-stage renal disease (ESRD) patients, particularly those on hemodialysis, face a significantly elevated risk of cardiovascular diseases (CVD), which represent the leading cause of mortality.
  • Traditional CVD risk factors do not fully explain the heightened risk observed in ESRD patients.
  • A specific T lymphocyte subset, CD4+CD28null T cells, has been associated with increased cardiovascular mortality in recent decades.

Purpose of the Study:

  • To investigate the frequency of circulating CD4+CD28null T cells in ESRD patients undergoing hemodialysis.
  • To evaluate the association between CD4+CD28null T cell frequency and the presence of atherosclerotic changes in these patients.

Main Methods:

  • The study involved 90 participants: 60 ESRD patients on hemodialysis (30 with atherosclerosis, 30 without) and 30 healthy controls.
  • High-resolution carotid ultrasonography was used to measure common carotid artery intima-media thickness (CIMT) for atherosclerosis assessment.
  • Flow cytometry was employed to quantify the frequency of circulating CD4+CD28null T cells in all subjects.

Main Results:

  • CD4+CD28null T cell percentage was significantly higher in ESRD patients (7.3%) compared to healthy individuals (3.0%) (p < 0.001).
  • ESRD patients exhibiting atherosclerotic changes showed a significantly greater expansion of CD4+CD28null T cells (9.47%) compared to those without atherosclerosis (5.22%) (p < 0.001).

Conclusions:

  • Circulating CD4+CD28null T lymphocytes are expanded in ESRD patients.
  • The expansion of CD4+CD28null T cells is correlated with preclinical atherosclerotic changes in ESRD patients on hemodialysis.
  • CD4+CD28null T cells may serve as a biomarker for cardiovascular risk in ESRD.

Keywords:
AtherosclerosisCD4(+)CD28(null) T cellsCarotid intima media thicknessESRD

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