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ESRD-associated immune phenotype depends on dialysis modality and iron status: clinical implications

BACKGROUND: End-stage renal disease (ESRD) causes premature ageing of the immune system. However, it is not known whether hemodialysis (HD) and peritoneal dialysis (PD) similarly affect the T cell system. METHODS: The aim of our study was to analyse whether dialysis modality may mitigate ESRD-induce...

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Autores principales: Ducloux, Didier, Legendre, Mathieu, Bamoulid, Jamal, Rebibou, Jean-Michel, Saas, Philippe, Courivaud, Cécile, Crepin, Thomas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6050655/
https://www.ncbi.nlm.nih.gov/pubmed/30026783
http://dx.doi.org/10.1186/s12979-018-0121-z
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author Ducloux, Didier
Legendre, Mathieu
Bamoulid, Jamal
Rebibou, Jean-Michel
Saas, Philippe
Courivaud, Cécile
Crepin, Thomas
author_facet Ducloux, Didier
Legendre, Mathieu
Bamoulid, Jamal
Rebibou, Jean-Michel
Saas, Philippe
Courivaud, Cécile
Crepin, Thomas
author_sort Ducloux, Didier
collection PubMed
description BACKGROUND: End-stage renal disease (ESRD) causes premature ageing of the immune system. However, it is not known whether hemodialysis (HD) and peritoneal dialysis (PD) similarly affect the T cell system. METHODS: The aim of our study was to analyse whether dialysis modality may mitigate ESRD-induced immune senescence. We explored a large population of patients (675 ESRD patients) and both confirmed and refined the results in a second cohort (84 patients). RESULTS: HD patients exhibited higher inflammatory monocytes counts (44/mm(3) (1–520) vs 36/mm(3) (1–161); p = 0.005). Patients on HD also had higher frequency of CD8 T cells (24% (7–61) vs 22% (8–42); p = 0.003) and reduced CD4/CD8 ratio. Such results were confirmed in the second cohort. Moreover, both CD4 + CD57 + CD28- (3.25% (0–38.2) vs 1.05% (0–28.5); p = 0.068) and CD8 + CD57 + CD28- (38.5% (3.6–76.8) vs 26.1 (2.1–46.9); p = 0.039) T cells frequencies were increased in HD patients. Telomere length did not differ according to dialysis modality, but was inversely related to ferritin levels (r = − 0.33; p = 0.003). There was a trend towards higher telomerase activity in PD patients (11 ± 13 vs 6 ± 11; p = 0.053). Thymic function was not different in PD and HD patients. Patients on PD before transplantation had a higher risk of acute rejection after kidney transplantation (HR, 1.61; 95%CI, 1.02 to 2.56; p = 0.041). CONCLUSIONS: More pronounced inflammation with hemodialysis may induce premature aging of the immune system. This observation correlates with a lower risk of acute kidney rejection in patients previously on HD. Clinical consequences in patients maintained on dialysis should be determined. TRIAL REGISTRATION: Trial registration: NCT02843867, registered July 8, 2016.
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spelling pubmed-60506552018-07-19 ESRD-associated immune phenotype depends on dialysis modality and iron status: clinical implications Ducloux, Didier Legendre, Mathieu Bamoulid, Jamal Rebibou, Jean-Michel Saas, Philippe Courivaud, Cécile Crepin, Thomas Immun Ageing Research BACKGROUND: End-stage renal disease (ESRD) causes premature ageing of the immune system. However, it is not known whether hemodialysis (HD) and peritoneal dialysis (PD) similarly affect the T cell system. METHODS: The aim of our study was to analyse whether dialysis modality may mitigate ESRD-induced immune senescence. We explored a large population of patients (675 ESRD patients) and both confirmed and refined the results in a second cohort (84 patients). RESULTS: HD patients exhibited higher inflammatory monocytes counts (44/mm(3) (1–520) vs 36/mm(3) (1–161); p = 0.005). Patients on HD also had higher frequency of CD8 T cells (24% (7–61) vs 22% (8–42); p = 0.003) and reduced CD4/CD8 ratio. Such results were confirmed in the second cohort. Moreover, both CD4 + CD57 + CD28- (3.25% (0–38.2) vs 1.05% (0–28.5); p = 0.068) and CD8 + CD57 + CD28- (38.5% (3.6–76.8) vs 26.1 (2.1–46.9); p = 0.039) T cells frequencies were increased in HD patients. Telomere length did not differ according to dialysis modality, but was inversely related to ferritin levels (r = − 0.33; p = 0.003). There was a trend towards higher telomerase activity in PD patients (11 ± 13 vs 6 ± 11; p = 0.053). Thymic function was not different in PD and HD patients. Patients on PD before transplantation had a higher risk of acute rejection after kidney transplantation (HR, 1.61; 95%CI, 1.02 to 2.56; p = 0.041). CONCLUSIONS: More pronounced inflammation with hemodialysis may induce premature aging of the immune system. This observation correlates with a lower risk of acute kidney rejection in patients previously on HD. Clinical consequences in patients maintained on dialysis should be determined. TRIAL REGISTRATION: Trial registration: NCT02843867, registered July 8, 2016. BioMed Central 2018-07-17 /pmc/articles/PMC6050655/ /pubmed/30026783 http://dx.doi.org/10.1186/s12979-018-0121-z Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Ducloux, Didier
Legendre, Mathieu
Bamoulid, Jamal
Rebibou, Jean-Michel
Saas, Philippe
Courivaud, Cécile
Crepin, Thomas
ESRD-associated immune phenotype depends on dialysis modality and iron status: clinical implications
title ESRD-associated immune phenotype depends on dialysis modality and iron status: clinical implications
title_full ESRD-associated immune phenotype depends on dialysis modality and iron status: clinical implications
title_fullStr ESRD-associated immune phenotype depends on dialysis modality and iron status: clinical implications
title_full_unstemmed ESRD-associated immune phenotype depends on dialysis modality and iron status: clinical implications
title_short ESRD-associated immune phenotype depends on dialysis modality and iron status: clinical implications
title_sort esrd-associated immune phenotype depends on dialysis modality and iron status: clinical implications
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6050655/
https://www.ncbi.nlm.nih.gov/pubmed/30026783
http://dx.doi.org/10.1186/s12979-018-0121-z
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