Humoral immunity to memory antigens and pathogens is maintained in patients with chronic kidney disease.
Humoral immunity to memory antigens and pathogens is maintained in patients with chronic kidney disease.
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DOI：
10.1371/journal.pone.0195730
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发表时间：
2018
期刊：
影响因子：
3.7
通讯作者：
Cunningham AF
中科院分区：
文献类型：
--
作者：
Wall NA;Dominguez-Medina CC;Faustini SE;Cook CN;McClean A;Jesky MD;Perez-Toledo M;Morgan MD;Richter AG;Ferro CJ;Cockwell P;Moss PA;Henderson IR;Harper L;Cunningham AF
慢性肾脏疾病(CKD)患者感染风险增加，对疫苗的反应较差。这表明CKD患者对所有抗原的反应性受损，即使是在CKD发病前首次遇到的抗原也是如此。为了验证这一点，我们在两个独立的队列中评估了对两种儿童疫苗抗原，破伤风(TT)和白喉类毒素(DT)以及两种常见病原体巨细胞病毒(CMV)和肠炎沙门氏菌(SEN)的抗体反应，该队列由患有和不患有CKD的年龄匹配的个体组成。用血清杀菌试验评价血清中抗原特异性的免疫球蛋白抗体效价，并评价抗SEN抗体的功能。令人惊讶的是，CKD患者和对照组的抗TT和DT的免疫球蛋白水平相当，这表明对生命早期遇到的抗原的体液记忆反应是保存的。CKD患者的内毒素特异性免疫球蛋白抗体滴度和血清杀菌活性也不低于对照组。血清阳性CKD患者的CMV特异性免疫球蛋白滴度与对照组相似，甚至升高。因此，虽然CKD对新疫苗的反应通常低于预期，但对CKD发病前常见的抗原的抗体反应并不是这样。CKD的免疫缺陷的特征可能是对新的抗原挑战没有反应，因此改善患者预后的努力应该集中在这里。
Patients with chronic kidney disease (CKD) have an increased risk of infection and poorer responses to vaccination. This suggests that CKD patients have an impaired responsiveness to all antigens, even those first encountered before CKD onset. To examine this we evaluated antibody responses against two childhood vaccine antigens, tetanus (TT) and diphtheria toxoids (DT) and two common pathogens, cytomegalovirus (CMV) and Salmonella enterica serovar Enteritidis (SEn) in two independent cohorts consisting of age-matched individuals with and without CKD. Sera were evaluated for antigen-specific IgG titres and the functionality of antibody to SEn was assessed in a serum bactericidal assay. Surprisingly, patients with CKD and control subjects had comparable levels of IgG against TT and DT, suggesting preserved humoral memory responses to antigens encountered early in life. Lipopolysaccharide-specific IgG titres and serum bactericidal activity in patients with CKD were also not inferior to controls. CMV-specific IgG titres in seropositive CKD patients were similar or even increased compared to controls. Therefore, whilst responses to new vaccines in CKD are typically lower than expected, antibody responses to antigens commonly encountered prior to CKD onset are not. The immunodeficiency of CKD is likely characterised by failure to respond to new antigenic challenges and efforts to improve patient outcomes should be focussed here.
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影响因子：
3.7
作者：
Hart PJ;O'Shaughnessy CM;Siggins MK;Bobat S;Kingsley RA;Goulding DA;Crump JA;Reyburn H;Micoli F;Dougan G;Cunningham AF;MacLennan CA
通讯作者：
MacLennan CA
影响因子：
2.9
作者：
Aitken GR;Roderick PJ;Fraser S;Mindell JS;O'Donoghue D;Day J;Moon G
通讯作者：
Moon G
影响因子：
5.4
作者：
Alonso Arias, R.;Moro-Garcia, M. A.;Lopez-Larrea, C.
通讯作者：
Lopez-Larrea, C.
影响因子：
15.9
作者：
MacLennan, Calman A.;Gondwe, Esther N.;Drayson, Mark T.
通讯作者：
Drayson, Mark T.
DOI：
10.1053/j.ajkd.2016.09.018
发表时间：
2017-06
期刊：
American journal of kidney diseases : the official journal of the National Kidney Foundation
影响因子：
--
作者：
Ishigami J;Grams ME;Chang AR;Carrero JJ;Coresh J;Matsushita K
通讯作者：
Matsushita K