T-rosettes in hemodialysis patients and renal allograft recipients

Studies on IL-2 production and T-cell colony forming unit in patients with chronic renal failure

To elucidate the nature of altered cellular immunity seen in patients with chronic renal failure, the values of interleukin-2 (IL-2), a kind of lymphokine, and T-cell colony forming units were measured in controls (N = 10), predialysis uremic patients (N = 14), patients undergoing chronic hemodialysis (HD, N = 11) and patients on continuous ambulatory peritoneal dialysis (CAPD, N = 9). Dialytic patients were selected as relatively stable cases receiving dialysis for more than 3 months. The duration of dialysis was 25.5 +/- 5.5 months in HD and 14.7 +/- 3.0 months in CAPD groups. The mean age was 30.3 years in the control, 36.1 years in the predialysis, 32.9 years in the HD and 41.1 years in the CAPD groups; all 4 groups showed male predominance. The serum creatinine concentration of each group was 1.2 +/- 0.1 mg/dl in the control, 14.1 +/- 0.9 mg/dl in predialysis, 13.5 +/- 1.3 mg/dl in HD and 14.7 +/- 0.9 mg/dl in CAPD groups. The level of IL-2 in the predialysis group was markedly lower compared to the control, HD and CAPD groups (as 3.1 +/- 0.8 unit vs. 8.8 +/- 2.2 unit, 11.8 +/- 3.0 unit and 14.9 +/- 3.4 unit, respectively, p < 0.05); the difference between the control and dialytic groups was not statistically significant.(ABSTRACT TRUNCATED AT 250 WORDS)

Suppressor cells assayed by numerical and functional tests in chronic renal failure

Suppressor cells were assayed by numerical and functional tests in adults on chronic hemodialysis. Peripheral blood mononuclears (PBM) were classified as total T-cells by E-rosettes and by the monoclonal antibody OKT3, as T-cell subsets by OKT4 (inducer/helper T-cells) and OKT8 (cytotoxic/suppressor T-cells) and as B-cells by the presence of surface immunoglobulin. The suppressive effect of PBM pretreated with either Concanavalin A (Con A), sodium periodate, or serum rich in immune complexes, on normal homologous phytohemagglutinin (PHA) lymphocyte transformation, was determined. Usual tests of T-cell function were not done. T lymphopenia was due to significant diminution (P less than 0.002) in numbers of OKT4+ cells in patients (516 +/- 44 cells/mm3, mean +/- sem) as compared to controls (906 +/- 96 cells/mm3). The number of OKT8+ cells in patients was not different from normal although their percentage (45 +/- 4%) was slightly higher than controls (36 +/- 5%) (P less than 0.10). Suppressor activity using only a suboptimal dose of Con A (5 micrograms/ml), was significantly lower (P less than 0.002) in uremic patients (36 +/- 12%) than in controls (67 +/- 7%). An important finding was that no significant correlations were detected between the numerical and functional assays of suppression used or between any of these immunological tests and biochemical parameters studied. The implications of these results for immunoparesis in uremia are discussed with particular reference to the discordance between marker and functional assays of suppressor cells.

Serial measurement of nonspecific immune parameters in chronically hemodialyzed renal failure patients

Nonspecific immune monitoring of the percentage active T (A-T) rosette-forming cells (RFC) and spontaneous blastogenesis (SB) appear to be useful indexes of host reaction toward allografts. In order to assess the significance of the observed changes, renal failure patients were serially evaluated before and after hemodialysis for the percentage of total T (T-T) and A-T RFC and for peripheral blood leukocyte metabolic activity measured by a whole blood spontaneous blastogenesis (SB) assay. Renal failure patients had a significantly lower (P less than 0.05) percentage of T-T RFC than normal persons, while the percentage A-T RFC and SB remained stable. A hemodialysis treatment did not change the mean values of any of the three parameters. On the other hand, serial patient evaluation over 3 months revealed significant fluctuations in the percentage T-T RFC, but not the percentage A-T RFC and SB. Since the percentage A-T RFC and SB are relatively constant measures of immune status in ungrafted patients, significant changes in these nonspecific immune probes may reflect allograft rejection.

Effect of haemo- and peritoneal dialysis on the cell-mediated immune response in chronic uraemia

Lymphocytopenia, decreased spontaneous rosette formation, and a decreased T lymphocyte count have been found in patients with non-uraemic glomerulonephritis (71 cases) and in different stages of uraemia (68 cases). In chronic glomerulonephritis and in the early stage of uraemia, cell-mediated hypersensitivity (lymphocyte migration inhibition) to glomerular basement membrane (GBM) characteristic of glomerulonephritis could be demonstrated. Hypersensitivity disappeared in the terminal stage of uraemia indicating endogenous immunosuppression.

Lymphocyte subpopulations in maintenance hemodialysis patients

Lymphocyte counts and T,B and null cell proportions were analyzed in forty non-splenectomized, non-nephrectomized maintenance hemodialysis patients, and compared with those in controls. The patients were lymphopenic, but had normal T, B and null cell percentages, regardless of tehir primary renal disease. It is postulated that their lymphocyte suppression is non-selective and may be related to the state of controlled azotemia or to the dialysis procedure.

Leukocyte mobilization by epinephrine and hydrocortisone in patients with chronic renal failure

The mobilization of WBC from the bone marrow, as judged from hydrocortisone-induced leucocytosis, is markedly impaired in dialyzed and nondialyzed uremic patients. The release of WBC from the marginal pool by epinephrine was found to be normal.