Influence of end stage renal disease on CD28 expression and T-cell immunity

Erasmia Sampani; Maria Stangou; Dimitra-Vasilia Daikidou; Vasiliki Nikolaidou; Despoina Asouchidou; Chrysostomos Dimitriadis; George Lioulios; Aliki Xochelli; Asimina Fylaktou; Aikaterini Papagianni

doi:10.1111/nep.13784

Influence of end stage renal disease on CD28 expression and T-cell immunity

Nephrology (Carlton). 2021 Feb;26(2):185-196. doi: 10.1111/nep.13784. Epub 2020 Sep 28.

Authors

Erasmia Sampani^{1

2}, Maria Stangou^{1

2}, Dimitra-Vasilia Daikidou^{1

2}, Vasiliki Nikolaidou^{1

2}, Despoina Asouchidou^{1

2}, Chrysostomos Dimitriadis^{1

2}, George Lioulios^{1

2}, Aliki Xochelli^{1

2}, Asimina Fylaktou^{1

2}, Aikaterini Papagianni^{1

2}

Affiliations

¹ Department of Nephrology, Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece.
² Department of Immunology, National Peripheral Histocompatibility Center, Hippokration Hospital, Thessaloniki, Greece.

PMID: 32935413
DOI: 10.1111/nep.13784

Abstract

Background: T-cell immunity is affected in end stage renal disease (ESRD). However, whether this happens at pre- or post-dialysis stage and what is the impact of different renal replacement methods, remains unclear. We investigated the alterations of T-cell subtypes in patients at pre-dialysis ESRD and their further changes during dialysis.

Methods: CD4+, CD8+, CD4 + CD28null and CD8 + CD28null T-cells were analysed in 40 ESRD patients at two different time points, (a) the day started on dialysis (ESRD-T0) and (b) 6 months later (ESRD-T6), while being on haemodialysis (HD) or continuous ambulatory peritoneal dialysis (CAPD). Twenty-five age matched healthy volunteers served as controls.

Results: CD4+ and CD8+ T-cells were significantly reduced in ESRD-T0 patients compared to controls, 604 (105-3551) vs 943 (584-1867)μ/L, P = .001, and 352 (103-1561) vs 422.4 (263-1453)μ/L, P = .05, respectively. However, proportions of CD4 + CD28null and CD8 + CD28null cells were significantly increased, 6.4 (0.3-30)% vs 2.7 (0.1-7.8)%, P = .04 and 58.2 (12.8-85.4)% vs 39 (7.8-57.1)%, P = .01, respectively. Proportion of CD4 + CD28null cells showed significant correlation with serum CRP (r = .4, P = .04) and albumin levels (r = -.5, P = .007) in ERSD patients. ESRD-T0 patients with cardiovascular disease (CVD) had increased CD4 + CD28null and CD8 + CD28null proportions, 8.6 (1-30)% vs 2.1 (0.1-19.8)%, P = .04 and 62.5 (12.8-85.4)% vs 45.5 (5.7-73.7)%, P = .02, respectively, compared to those without. Six months later, both CD4 + CD28null and CD8 + CD28null T-cells were increased in HD compared to CAPD patients, by +110.11 (-27.1 to 311.4)% vs -28.1 (-100 to 30)%, P = .003 and +55.23 (-29.06 to 197.93)% vs -8.34 (-54.99 to 66.72)%, P = .05, respectively.

Conclusions: CD4 + CD28null and CD8 + CD28null T-cells are increased at pre-dialysis ESRD, and correlate with chronic inflammatory markers and the presence of CVD. Dialysis methods seem to have different impact on these subpopulations.

Keywords: CD4 + CD28null T-cells; CD8 + CD28null T-cells; cardiovascular disease; dialysis modalities.

Publication types

Comparative Study
Observational Study

MeSH terms

Aged
CD28 Antigens / metabolism*
CD4 Lymphocyte Count
CD4-Positive T-Lymphocytes / immunology*
CD4-Positive T-Lymphocytes / metabolism
CD8-Positive T-Lymphocytes / immunology*
CD8-Positive T-Lymphocytes / metabolism
Case-Control Studies
Female
Hemodiafiltration
Humans
Kidney Failure, Chronic / diagnosis
Kidney Failure, Chronic / immunology*
Kidney Failure, Chronic / metabolism
Kidney Failure, Chronic / therapy
Longitudinal Studies
Male
Middle Aged
Peritoneal Dialysis, Continuous Ambulatory
Prospective Studies
Time Factors
Treatment Outcome

Substances

CD28 Antigens