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Changes in the phagocytic cells in children treated with continuous ambulatory peritoneal dialysis
1Department of Laboratory Diagnostics and Clinical Immunology, University Medical School, Warsaw, Poland.
Insights
Children on continuous ambulatory peritoneal dialysis (CAPD) experience increased peritoneal macrophage (PM) activity and improved bacterial defense, despite lower PM counts. Blood neutrophils (PMNC) showed reduced receptor expression and function in these patients.
Area of Science:
- Immunology
- Nephrology
- Pediatrics
Background:
- Children with end-stage renal failure on continuous ambulatory peritoneal dialysis (CAPD) are at high risk for peritonitis.
- Peritoneal macrophages (PM) and blood neutrophils (PMNC) are critical for combating microbial infections in CAPD patients.
Purpose of the Study:
- To evaluate the expression of surface receptors on PM and PMNC in children undergoing CAPD.
- To assess the phagocytic and bactericidal capabilities of PM and PMNC in this patient group.
Main Methods:
- Analysis of surface receptor expression (CD16, CD35) on peritoneal macrophages and blood neutrophils.
- Assessment of phagocytosis and intracellular killing of bacteria by these immune cells.
- Comparison of immune cell function and receptor expression between CAPD patients and healthy controls, and over time during CAPD treatment.
Main Results:
- Peritoneal macrophages (PM) showed increased viability, activity, and expression of CD16 and CD35 during CAPD.
- Blood neutrophils (PMNC) from uremic children had lower expression of CD16 and CD35 compared to controls.
- CAPD improved phagocytosis and intracellular killing by PM, but not by PMNC.
Conclusions:
- Continuous ambulatory peritoneal dialysis enhances the function of peritoneal macrophages in children with end-stage renal failure.
- Uremia and CAPD significantly impact the surface antigen expression and functional capacity of phagocytes, particularly PMNC.
- The findings highlight the adaptive immune response of peritoneal macrophages during CAPD and the compromised function of neutrophils.
Abstract:
Children on continuous ambulatory peritoneal dialysis (CAPD) in endstage renal failure are highly exposed to peritonitis. Peritoneal macrophages (PM) and blood neutrophils (PMNC) are the first line of defense against invading microbes. This study was undertaken for assessing surface receptors expression on PM and PMNC and to check their ability to phagocytosis and killing of bacteria. We have found that in spite of the decreased number of PM in dialysate fluid their viability and activity significantly increased during CAPD. Moreover, higher number of PM expressed CD16 and CD35 antigens (FcRIII and C3bR, respectively) in comparison with the results observed at CAPD onset. The number of PMNC expressed of these two antigens in uremic children blood were significantly lower in comparison with healthy control. The number of CD16 positive cells increased under influence of CAPD only temporarily. CAPD caused improvement of phagocytosis and intracellular killing of bacteria by PM but not by PMNC. There is discussed here influence of uremia and CAPD on surface antigens, function of phagocytes as well as renewal of PM during CAPD.