[Abnormalities of cellular immunity in uremic patients]

In order to clarify the abnormalities of cellular immune responses in uremic patients, we studied several immunological parameters such as T cell subsets, the number of B cells, in vitro immunoglobulin production by peripheral blood mononuclear cells (PBMC) with or without addition of pokeweed mitogen or IL-2 in 19 patients on chronic hemodialysis (HD), 42 patients on continuous ambulatory peritoneal dialysis (CAPD) and 27 healthy volunteers. The CD4/CD8 ratio was significantly higher in HD and CAPD patients than in the control group. Higher activated T cell counts (T cells with DR antigen and IL-2R) were observed in the patient groups than in normal controls. The number of DR + T cells showed a positive correlation with the level of serum beta 2 MG in patient groups. Spontaneous synthesis of immunoglobulin in vitro in mononuclear cell culture was observed in all groups in the following order; control, CAPD and HD. The number of B cells (CD19+) was less in the patient groups than in the control group. There was a positive correlation between the serum levels of beta 2 MG and the degree of activated T cell markers. It is concluded that altered function in T and B cells might be responsible for various immunological abnormalities observed in patients with chronic renal failure on HD or CAPD.