Immune deficiency in uremia: interleukin-2 production and responsiveness and interleukin-2 receptor expression and release.
Immune deficiency in uremia: interleukin-2 production and responsiveness and interleukin-2 receptor expression and release.
复制标题
尿毒症中的免疫缺陷：白细胞介素 2 的产生和反应性以及白细胞介素 2 受体的表达和释放。
作者：
Donati,D;Degiannis,D;Homer,L;Gastaldi,L;Raskova,J;RaskaJr,K
我们研究了白细胞介素2（IL-2）及其受体在铜蛋白膜治疗的血液透析患者的体外淋巴细胞反应特征受损中的作用。血液透析患者的T淋巴细胞增殖反应以及T细胞依赖性B细胞增殖在有丝分裂原刺激后显著降低。在平行培养物中进行这种刺激后，发现患者和对照组的IL-2体外产生相似。血透组淋巴细胞膜IL-2受体表达与对照组相似。然而，尿毒症淋巴细胞对外源性IL-2的体外增殖反应显著抑制，表明生物活性IL-2受体的可用性降低。患者组中凝集素刺激培养的淋巴细胞释放可溶性IL-2受体也显著降低;然而，血液透析患者具有显著升高的血浆可溶性IL-2受体水平，并且在通过醋酸纤维素、聚砜和聚丙烯腈膜透析的其他三组终末期肾病患者中也发现了类似的高水平，以及一组接受保守治疗的尿毒症患者。在血液透析患者组中，可溶性IL-2受体水平与血液透析持续时间呈显著正相关，由于可溶性IL-2受体已被报道下调淋巴细胞反应，血液透析患者血浆可溶性IL-2受体水平的升高可能是终末期肾病相关免疫功能受损进展的一个致病因素。
We have studied the role of interleukin-2 (IL-2) and its receptors in the impaired in vitro lymphocyte response characteristic of hemodialysis patients treated by means of cuprophane membranes. The proliferative response of T lymphocytes as well as T-cell-dependent B cell proliferation after stimulation with mitogens was significantly reduced in hemodialysis patients. The in vitro production of IL-2 after such stimulation in parallel cultures was found to be similar in patients and in controls. The expression of IL-2 receptor on the lymphocyte cellular membrane in the hemodialysis group was also similar to controls. The in vitro proliferative response of uremic lymphocytes to exogenous IL-2, however, was significantly depressed suggesting a reduced availability of biologically active IL-2 receptor. The release of soluble IL-2 receptor by lectin-stimulated lymphocytes in culture was also significantly lower in the patient group; yet, hemodialysis patients has a strikingly elevated level of plasma soluble IL-2 receptor, and similar high levels were also found in three other groups of end-stage renal disease patients dialyzed by means of cellulose acetate, polysulfone and polyacrylonitrile membranes, as well as in a group of uremic patients on conservative treatment. In the hemodialysis patient group a significant positive correlation between levels of soluble IL-2 receptor and the duration of hemodialysis was found. Since soluble IL-2 receptor has been reported to down-regulate lymphocyte responses, the elevation in plasma levels of soluble IL-2 receptor in hemodialysis patients may be a pathogenetic factor in the progressive development of impaired immunity associated with end-stage renal disease.