Increased interleukin-17 producing effector memory T cells in the end-stage renal disease patients

sPatients with end-stage renal disease (ESRD) exhibit immune dysregulation, but the precise immunological profile and the effect of hemodialysis (HD) on it has not been investigated fully. Thirty-eight ESRD patients (22 on HD and 16 in pre-dialysis) and 24 healthy volunteers were included. We compared the T cell immune profiles as in these patients. Among the effector T cell subset, the percentages of Th17 and Th2 cells were significantly higher in the ESRD group than in the healthy controls (P < 0.05). The percentage of Th1 cells did not differ significantly between these groups. The percentages of Th1, Th2 and Th17 cells did not differ significantly (P > 0.05) between the two subgroups within the ESRD group. The CCR4−CCR6+/CD4+ T cell percentage was also significantly higher in the ESRD group. The naïve T cell (Tnaïve) percentage was significantly lower in the ESRD group, and the difference between patients and controls was greater in the pre-dialysis patients than in the HD patients (P < 0.05, for each comparison). By contrast, the percentages of central memory T cells (TCM) and effector memory T (TEM) cells were significantly higher in the ESRD group. Interleukin-17 production by TEM cells was significantly higher in the ESRD group. The severity of uremia was related negatively to the Tnaïve cell percentage but positively to the TCM and TEM cell percentages. The percentages of TEM and CD45RA+ T effector memory subsets of CD8+ T cells were significantly higher in the ESRD group (P < 0.05). The result of this study showed significantly altered T cell-associated immunity and that it could not be corrected with hemodialysis.

► ESRD patients showed a significantly different T cell-associated immunologic profile compared with the general population. ► The main finding is the increase in the percentage of Th17 and Th2 cells within the effector T cell subset, which may reflect continuous immune activation associated with atherosclerosis. ► The decrease in the percentage of Tnaïve cells may be associated with immune impairment. ► The results of this study might indicate a need to develop therapeutic options to treat immune dysregulation in ESRD patients.