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Hemodialysis-Associated Immune Dysregulation in SARS-CoV-2-Infected End-Stage Renal Disease Patients

Patients on hemodialysis show dysregulated immunity, basal hyperinflammation and a marked vulnerability to COVID-19. We evaluated the immune profile in COVID-19 hemodialysis patients and the changes associated with clinical deterioration after the hemodialysis session. Recruited patients included ei...

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Autores principales: González-Cuadrado, Cecilia, Caro-Espada, Paula Jara, Chivite-Lacaba, Marta, Utrero-Rico, Alberto, Lozano-Yuste, Claudia, Gutierrez-Solis, Elena, Morales, Enrique, Sandino-Pérez, Justo, Gil-Etayo, Francisco Javier, Allende-Martínez, Luis, Laguna-Goya, Rocio, Paz-Artal, Estela
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9865754/
https://www.ncbi.nlm.nih.gov/pubmed/36675231
http://dx.doi.org/10.3390/ijms24021712
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author González-Cuadrado, Cecilia
Caro-Espada, Paula Jara
Chivite-Lacaba, Marta
Utrero-Rico, Alberto
Lozano-Yuste, Claudia
Gutierrez-Solis, Elena
Morales, Enrique
Sandino-Pérez, Justo
Gil-Etayo, Francisco Javier
Allende-Martínez, Luis
Laguna-Goya, Rocio
Paz-Artal, Estela
author_facet González-Cuadrado, Cecilia
Caro-Espada, Paula Jara
Chivite-Lacaba, Marta
Utrero-Rico, Alberto
Lozano-Yuste, Claudia
Gutierrez-Solis, Elena
Morales, Enrique
Sandino-Pérez, Justo
Gil-Etayo, Francisco Javier
Allende-Martínez, Luis
Laguna-Goya, Rocio
Paz-Artal, Estela
author_sort González-Cuadrado, Cecilia
collection PubMed
description Patients on hemodialysis show dysregulated immunity, basal hyperinflammation and a marked vulnerability to COVID-19. We evaluated the immune profile in COVID-19 hemodialysis patients and the changes associated with clinical deterioration after the hemodialysis session. Recruited patients included eight hemodialysis subjects with active, PCR-confirmed SARS-CoV-2 infection, five uninfected hemodialysis patients and five healthy controls. In SARS-CoV-2-infected hemodialysis patients TNF-α, IL-6 and IL-8 were particularly increased. Lymphopenia was mostly due to reduction in CD4+ T, B and central memory CD8+ T cells. There was a predominance of classical and intermediate monocytes with reduced HLA-DR expression and enhanced production of pro-inflammatory molecules. Immune parameters were analysed pre- and post-hemodialysis in three patients with COVID-19 symptoms worsening after the hemodialysis session. There was a higher than 2.5-fold increase in GM-CSF, IFN-γ, IL-1β, IL-2, IL-6, IL-17A and IL-21 in serum, and augmentation of monocytes-derived TNF-α, IL-1β and IL-8 and CXCL10 (p < 0.05). In conclusion, COVID-19 in hemodialysis patients associates with alteration of lymphocyte subsets, increasing of pro-inflammatory cytokines and monocyte activation. The observed worsening during the hemodialysis session in some patients was accompanied by augmentation of particular inflammatory cytokines, which might suggest biomarkers and therapeutic targets to prevent or mitigate the hemodialysis-related deterioration during SARS-CoV-2 infection.
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spelling pubmed-98657542023-01-22 Hemodialysis-Associated Immune Dysregulation in SARS-CoV-2-Infected End-Stage Renal Disease Patients González-Cuadrado, Cecilia Caro-Espada, Paula Jara Chivite-Lacaba, Marta Utrero-Rico, Alberto Lozano-Yuste, Claudia Gutierrez-Solis, Elena Morales, Enrique Sandino-Pérez, Justo Gil-Etayo, Francisco Javier Allende-Martínez, Luis Laguna-Goya, Rocio Paz-Artal, Estela Int J Mol Sci Article Patients on hemodialysis show dysregulated immunity, basal hyperinflammation and a marked vulnerability to COVID-19. We evaluated the immune profile in COVID-19 hemodialysis patients and the changes associated with clinical deterioration after the hemodialysis session. Recruited patients included eight hemodialysis subjects with active, PCR-confirmed SARS-CoV-2 infection, five uninfected hemodialysis patients and five healthy controls. In SARS-CoV-2-infected hemodialysis patients TNF-α, IL-6 and IL-8 were particularly increased. Lymphopenia was mostly due to reduction in CD4+ T, B and central memory CD8+ T cells. There was a predominance of classical and intermediate monocytes with reduced HLA-DR expression and enhanced production of pro-inflammatory molecules. Immune parameters were analysed pre- and post-hemodialysis in three patients with COVID-19 symptoms worsening after the hemodialysis session. There was a higher than 2.5-fold increase in GM-CSF, IFN-γ, IL-1β, IL-2, IL-6, IL-17A and IL-21 in serum, and augmentation of monocytes-derived TNF-α, IL-1β and IL-8 and CXCL10 (p < 0.05). In conclusion, COVID-19 in hemodialysis patients associates with alteration of lymphocyte subsets, increasing of pro-inflammatory cytokines and monocyte activation. The observed worsening during the hemodialysis session in some patients was accompanied by augmentation of particular inflammatory cytokines, which might suggest biomarkers and therapeutic targets to prevent or mitigate the hemodialysis-related deterioration during SARS-CoV-2 infection. MDPI 2023-01-15 /pmc/articles/PMC9865754/ /pubmed/36675231 http://dx.doi.org/10.3390/ijms24021712 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
González-Cuadrado, Cecilia
Caro-Espada, Paula Jara
Chivite-Lacaba, Marta
Utrero-Rico, Alberto
Lozano-Yuste, Claudia
Gutierrez-Solis, Elena
Morales, Enrique
Sandino-Pérez, Justo
Gil-Etayo, Francisco Javier
Allende-Martínez, Luis
Laguna-Goya, Rocio
Paz-Artal, Estela
Hemodialysis-Associated Immune Dysregulation in SARS-CoV-2-Infected End-Stage Renal Disease Patients
title Hemodialysis-Associated Immune Dysregulation in SARS-CoV-2-Infected End-Stage Renal Disease Patients
title_full Hemodialysis-Associated Immune Dysregulation in SARS-CoV-2-Infected End-Stage Renal Disease Patients
title_fullStr Hemodialysis-Associated Immune Dysregulation in SARS-CoV-2-Infected End-Stage Renal Disease Patients
title_full_unstemmed Hemodialysis-Associated Immune Dysregulation in SARS-CoV-2-Infected End-Stage Renal Disease Patients
title_short Hemodialysis-Associated Immune Dysregulation in SARS-CoV-2-Infected End-Stage Renal Disease Patients
title_sort hemodialysis-associated immune dysregulation in sars-cov-2-infected end-stage renal disease patients
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9865754/
https://www.ncbi.nlm.nih.gov/pubmed/36675231
http://dx.doi.org/10.3390/ijms24021712
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