PD-1 and LAG-3 positive T cells are related with the prognosis of patients with chronic kidney disease

Our objective was to study the frequency of circulating LAG-3⁺ and PD-1⁺ T cells in chronic kidney disease (CKD) patients and their correlation with cytokines and patient prognosis.

A total of 83 patients with CKD between June 2020 and June 2022 were enrolled. We measured serum levels of IL-6, CRP, IL-1β, and TNF-α by ELISA. The frequency of PD-1⁺ and LAG-3⁺ T cells was measured using flow cytometry. All patients were followed up for 1 year, and the occurrence of any of the following conditions during the follow-up period was considered as major adverse cardiac events (MACE) indicating poor prognosis.

The frequencies of LAG-3⁺PD-1⁺, LAG-3⁺ and PD-1⁺ cells were significantly increased in CKD group compared to healthy volunteers. Additionally, CKD patients had remarkably enhanced levels of cytokines. Compared to the non-MACE group, MACE group had significantly higher frequencies of LAG-3PD-1, LAG-3 and PD-1 expression on CD8 and CD4. Positive correlations were observed between IL-1β, IL-6 and frequencies of PD-1⁺LAG-3⁺. CD4⁺LAG-3⁺PD-1⁺ frequency displayed the highest diagnostic value for CKD patients with MACE. Moreover, CD8⁺LAG-3⁺, CD4⁺LAG-3⁺PD-1⁺, CD4⁺PD-1⁺, IL-1β and IL-6 were identified as risk factors for the occurrence of MACE in patients with CKD.

In summary, the present research showed that the frequencies of LAG-3⁺ and PD-1⁺ T cells were remarkably enhanced in CKD patients. These findings offer novel insights and potential therapeutic targets for the management of CKD.