Hemodialysis patients exhibit T-cell activation accompanied by an enhanced frequency of IFN-γ+CD4+/CD8+ T cells

Abstract

T-cell immune dysregulation is common in end-stage renal disease (ESRD), but whether hemodialysis (HD) differentially affects T-cell immune activity remains unclear. We evaluated the peripheral T-cell immune characteristics of 96 patients with ESRD and 86 healthy controls to explore the effects of HD on T-cell immune function. T-cell subsets were analyzed by flow cytometry for phenotype, number, and function (represented by interferon-gamma [IFN-γ] secretion capacity). Compared with healthy controls, patients with ESRD showed significant reductions in the absolute number of CD8 + T-naïve (TN)/T effector memory (TEM)/T effector memory regulatory (TEMRA), CD4 + T-cell memory (TCM), CD4 + CD38 + , CD8 + /CD4 + HLA-DR + , and CD8 + /CD4 + CD28 + cells, especially in the proportion and quantity of CD4 + TN cells. Compared with nHD patients, HD patients showed significantly different peripheral T-cell immune characteristics. Phenotypically, the changes in CD4 + T-cell subsets were more significant than those observed for CD8 + T cells, with activated T cells (CD4 + CD38 + , CD4 + HLA-DR + , and CD8 + CD38 + T cells) increased and functional T cells (CD4 + CD28 + T cells) decreased in proportion and quantity. Functionally, the frequency of IFN-γ + CD4 + /CD8 + T cells was significantly higher in HD patients than in nHD patients, indicating the enhanced functional activation of T cells under HD. In summary, maintenance HD is associated with dysregulation of T-cell homeostasis in patients with ESRD, which is characterized by dual features of enhanced T-cell phenotype activation and functional activation (increased IFN-γ secretion). By evaluating the immune status on the basis of the secretion function of IFN-γ, our study provides valuable insights into immune imbalance in patients with ESRD.