A comprehensive characterization of aggravated aging-related changes in T lymphocytes and monocytes in end-stage renal disease: the iESRD study
A comprehensive characterization of aggravated aging-related changes in T lymphocytes and monocytes in end-stage renal disease: the iESRD study
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DOI：
10.1186/s12979-018-0131-x
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发表时间：
2018-11-08
影响因子：
7.9
通讯作者：
Chuang, Yi-Fang
中科院分区：
文献类型：
--
作者：
Chiu, Yen-Ling;Shu, Kai-Hsiang;Chuang, Yi-Fang
研究背景终末期肾病（ESRD）患者的免疫系统表现出早衰的表型。然而，这些变化在ESRD patients的病因和影响仍然unknown.ResultsCompared to healthy individuals，ESRD患者表现出加速免疫衰老的T细胞和单核细胞的车厢，其特征是显着减少幼稚的CD 4+和CD 8 + T细胞的数量，但增加CD 8 + T-EMRA细胞和促炎单核细胞的数量。值得注意的是，在终末期肾病患者中，与年龄相关的免疫变化不仅与年龄增加呈正相关，而且与透析年限更长呈正相关。在多变量校正的logistic回归模型中，在校正年龄、性别、全身炎症和糖尿病后，高终末分化CD 8 + T细胞水平和高中间单核细胞水平的组合作为复合预测免疫表型，与流行性冠状动脉疾病以及心血管疾病独立相关。终末分化的CD 8 + T细胞的水平也呈正相关，尿毒症毒素对甲苯基sulfate.ConclusionsAging-associated适应性和先天性免疫的变化加剧终末期肾病，并与心血管疾病的水平。我们的研究第一次证明了终末期肾病的免疫衰老与尿毒症环境暴露时间之间的潜在联系。
BackgroundPatients with end-stage renal disease (ESRD) exhibit a premature aging phenotype of the immune system. Nevertheless, the etiology and impact of these changes in ESRD patients remain unknown.ResultsCompared to healthy individuals, ESRD patients exhibit accelerated immunosenescence in both T cell and monocyte compartments, characterized by a dramatic reduction in naive CD4+ and CD8+ T cell numbers but increase in CD8+ T-EMRA cell and proinflammatory monocyte numbers. Notably, within ESRD patients, aging-related immune changes positively correlated not only with increasing age but also with longer dialysis vintage. In multivariable-adjusted logistic regression models, the combination of high terminally differentiated CD8+ T cell level and high intermediate monocyte level, as a composite predictive immunophenotype, was independently associated with prevalent coronary artery disease as well as cardiovascular disease, after adjustment for age, sex, systemic inflammation and presence of diabetes. Levels of terminally differentiated CD8+ T cells also positively correlated with the level of uremic toxin p-cresyl sulfate.ConclusionsAging-associated adaptive and innate immune changes are aggravated in ESRD and are associated with cardiovascular diseases. For the first time, our study demonstrates the potential link between immunosenescence in ESRD and duration of exposure to the uremic milieu.