Abstract:

Objective To investigate the changes of capacity of differentiation and maturation of dendritic cells (DC) in peripheral blood in patients with end-stage renal disease (ESRD) undergoing maintenance hemodialysis, and explore the possible mechanism of impaired immune responses of patients with ESRD. Methods The peripheral blood samples of patients with ESRD undergoing maintenance hemodialysis (ESRD group, n=20) were collected, and in vitro culture with granulocyte-macrophage colony-stimulating factor (GM-CSF), interleukin-4 (IL-4) and lipopolysaccharide (LPS) was conducted. The expression of CD40, CD80, CD86, CD83, CCR7 and HLA-DR on the surface of DC was detected by flow cytometry, and the level of interleukin-12 (IL-12) in the culture supernatant of DC was determined by enzyme-linked immunosorbent assay (ELISA). Besides, normal control group was established (n=20). Results The expression of CD40, CD80, CD86, CD83, CCR7 and HLA-DR on the surface of DC in ESRD group was significantly lower than that in normal control group (P<0.05, P<0.01). The level of IL-12 in the culture supernatant of DC in ESRD group was significantly higher than that in normal control group (P<0.01). Conclusion Peripheral blood monocyte-derived DC of patients with ESRD are immature, with the decrease in chemotactic function, migration ability and exogenous antigen-presenting capacity. The reduction of immune activation capacity of DC is likely to further participate in the immune dysfunction of T cells, and ultimately induces specific immune tolerance.

Key words: end-stage renal disease, maintenance hemodialysis, dendritic cells, surface molecules, cytokines