Journal Article

Impairment of innate cellular response to <i>in vitro</i> stimuli in patients on continuous ambulatory peritoneal dialysis

Minoru Ando, Asuka Shibuya, Masako Yasuda, Naoko Azuma, Ken Tsuchiya, Takashi Akiba and Kousaku Nitta

in Nephrology Dialysis Transplantation

Published on behalf of European Renal Association - European Dialysis and Transplant Assoc

Volume 20, issue 11, pages 2497-2503
Published in print November 2005 | ISSN: 0931-0509
Published online August 2005 | e-ISSN: 1460-2385 | DOI:
Impairment of innate cellular response to in vitro stimuli in patients on continuous ambulatory peritoneal dialysis

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Background. Most crucial in the initial stages of host defence against invading micro-organisms is innate immunity, in which peripheral mononuclear cells, in particular cytokines, are pivotal. Mortality from infections is high in dialysis patients, but it remains unclear if this arises from the ineffectiveness of innate immune mechanisms.

Methods. In 20 haemodialysis (HD) patients, 20 patients on continuous ambulatory peritoneal dialysis (CAPD), and 15 age-matched controls, we studied cytokine production by monocytes and helper T-cells in response to in vitro stimuli. The most important early-response cytokines for innate immunity, tumour necrosis factor (TNF)-α and interleukin (IL)-1β, were tested in monocytes, and interferon-γ and IL-4 were studied as indicators of polarization of helper T-cells into type 1 and type 2 cells. Peripheral blood cells stimulated with lipopolysaccharide or mitogen were labelled with anti-CD14+ and -CD4+ antibodies and then subjected to intracellular cytokine staining and flow cytometry.

Results. CAPD patients showed significantly reduced synthesis of TNF-α and IL-1β and inhibited T helper phenotype development compared with HD patients and control subjects. In contrast, HD patients showed an unaltered monokine response and a marked polarization of helper T-cells towards the type 1 phenotype. We also found that a single HD treatment potentiated monocytes to synthesize TNF-α.

Conclusions. Circulating immune cells in CAPD patients may be hyporeactive against infections, indicating an unfavourable innate host defence.

Keywords: helper T-cell; IL-1β; intracellular cytokine; monocyte; TNF-α

Journal Article.  3709 words.  Illustrated.

Subjects: Nephrology

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