Suppressor cells assayed by numerical and functional tests in chronic renal failure

Area of Science:

• Immunology
• Nephrology

Background:

• Chronic kidney disease and uremia are associated with immune dysregulation.
• Assessing immune cell function is crucial for understanding patient outcomes.

Purpose of the Study:

• To evaluate numerical and functional aspects of suppressor cells in adults undergoing chronic hemodialysis.
• To investigate potential discordance between T-cell subset counts and their functional suppressive activity in uremic patients.

Main Methods:

• Peripheral blood mononuclear cells (PBM) were analyzed for T-cell subsets (OKT4+, OKT8+) and B-cells.
• Suppressor cell activity was assessed by measuring the effect of pretreated PBM on normal lymphocyte transformation.
• Statistical analysis compared patient and control groups, examining correlations between immunological and biochemical parameters.

Main Results:

• Patients on hemodialysis exhibited a significant decrease in OKT4+ (inducer/helper) T-cells compared to controls.
• While OKT8+ (cytotoxic/suppressor) T-cell numbers were similar, their percentage was slightly elevated.
• Functional suppressor activity, measured with suboptimal Concanavalin A, was significantly lower in uremic patients.
• No significant correlations were found between numerical and functional immune assays or with biochemical parameters.

Conclusions:

• Hemodialysis patients demonstrate T-lymphopenia primarily due to reduced OKT4+ cells.
• Impaired suppressor cell function is evident in uremia, independent of OKT8+ cell numbers.
• A notable discordance exists between T-cell marker assays and functional suppressor cell assays in uremia, suggesting complex immune dysregulation.