Basic Science and Dialysis: Disturbances of Acquired Immunity in Hemodialysis Patients
- 11 July 2007
- journal article
- review article
- Published by Wiley in Seminars in Dialysis
- Vol. 20 (5), 440-451
- https://doi.org/10.1111/j.1525-139x.2007.00283.x
Abstract
Acquired immunity disturbances in hemodialysis (HD) patients are many and diverse. They are caused by uremia per se, the HD procedure, chronic renal failure complications, and therapeutic interventions for their treatment. Current data suggest that acquired immunity disturbances in HD patients concern mainly the T-lymphocyte and the antigen-presenting cell (APC). The T-lymphocyte-dependent immune response is deficient, predisposing to infections and inadequate response to vaccinations. In addition, APCs are preactivated, which seems to be responsible for the malnutrition-inflammation-atherosclerosis syndrome, and also affects T-lymphocyte function. At the molecular level it is assumed that the interaction between the APC and the T-lymphocyte is impaired. This disturbance is likely to concern the signal that results from the interaction between the major histocompatibility complex:peptide complex on APC surfaces and T-cell receptors on T-lymphocyte surfaces, or the signal that results from the interaction among the co-receptors of these two cells. The aim of the present review was to collect and classify the available clinical and experimental data in this area. Although many pieces are still missing from the puzzle, a better understanding of the responsible molecular mechanisms, will potentially lead to increased survival and a better quality of life in HD patients. © 2007 Blackwell PublishingKeywords
This publication has 158 references indexed in Scilit:
- Direct observation of ligand recognition by T cellsNature, 2002
- Cell adhesion and polarity during immune interactionsImmunological Reviews, 2002
- Protein-energy malnutrition as a risk factor for increased morbidity in long-term hemodialysis patientsJournal of Renal Nutrition, 2000
- Influence of dialysis with polyamide vs haemophan haemodialysis on monokines and complement activation during a 4-month long-term studyNephrology Dialysis Transplantation, 1999
- Influence of Recombinant Human Erythropoietin Therapy on in vivo Chemotaxis and in vitro Phagocytosis of Polymorphonuclear Cells of Hemodialysis PatientsBlood Purification, 1996
- Cellular Immunity in Hemodialysis Patients: A Quantitative Analysis of Immune Cell Subsets by Flow CytometryAmerican Journal of Nephrology, 1995
- Gene expression of interleukin-1β during hemodialysisKidney International, 1993
- Hepatitis B Vaccine in Patients Receiving HemodialysisNew England Journal of Medicine, 1984
- The Long-Term Clinical Course of Systemic Lupus Erythematosus in End-Stage Renal DiseaseNew England Journal of Medicine, 1983
- Lymphocytes from Multitransfused Uremic Patients Have Poor MLC ReactivityTissue Antigens, 1981