外周血T淋巴细胞亚群对慢性肾脏病患者发生终点事件的预测价值

谯羽; 熊加川; 赵景宏

doi:10.16016/j.1000-5404.202008018

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外周血T淋巴细胞亚群对慢性肾脏病患者发生终点事件的预测价值

临床医学 | 更新时间：2026-01-09

- 外周血T淋巴细胞亚群对慢性肾脏病患者发生终点事件的预测价值
- Reduction of T cell subpopulations peripheral blood is a predictor of renal endpoint events in patients with chronic kidney disease
- 第三军医大学学报 2021年43卷第5期页码：438-445
- 作者机构：
- 作者简介：
- 基金信息：
  
  陆军军医大学临床医学科研人才培养计划(2018XLC1007)
- DOI：10.16016/j.1000-5404.202008018
  中图分类号：
- 收稿：2020-08-03，
  
  纸质出版：2021-03-15
- 稿件说明：
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谯羽, 熊加川, 赵景宏. 外周血T淋巴细胞亚群对慢性肾脏病患者发生终点事件的预测价值[J]. 第三军医大学学报, 2021,43(5):438-445.

Yu QIAO, Jiachuan XIONG, Jinghong ZHAO. Reduction of T cell subpopulations peripheral blood is a predictor of renal endpoint events in patients with chronic kidney disease[J]. Journal of Third Military Medical University, 2021, 43(5): 438-445.
谯羽, 熊加川, 赵景宏. 外周血T淋巴细胞亚群对慢性肾脏病患者发生终点事件的预测价值[J]. 第三军医大学学报, 2021,43(5):438-445. DOI： 10.16016/j.1000-5404.202008018.

Yu QIAO, Jiachuan XIONG, Jinghong ZHAO. Reduction of T cell subpopulations peripheral blood is a predictor of renal endpoint events in patients with chronic kidney disease[J]. Journal of Third Military Medical University, 2021, 43(5): 438-445. DOI： 10.16016/j.1000-5404.202008018.

摘要

Abstract

Objective

To investigate the correlation between the counts of CD3

CD4

and CD8

T cells in peripheral blood as well as the ratio of CD4

/CD8

T cells and the renal endpoint events (renal substitutive therapy) in patients with chronic kidney disease (CKD)

and to determine whether these T cell parameters are prognostic indicators for pre-dialysis CKD patients.

Methods

A total of 568 pre-dialysis patients with primary CKD at stage 3~5 admitted in our hospital from March 2015 to January 2019 were enrolled and followed up in this study. Immunofluorescence flow cytometry was adopted to detect the counts of CD3

CD4

and CD8

T cells

and the ratio of CD4

/CD8

T cells was calculated. The CKD patients then were divided into normal- and low-level groups of CD3

CD4

and CD8

T cell counts

according to the clinical reference values. The renal endpoint event was defined as initiation of a renal substitutive therapy duo to irreversible deterioration of kidney function

including peritoneal dialysis

hemodialysis

and kidney transplantation. Kaplan-Meier analysis was used to compare the survival time betw

een the 2 groups. Cox regression model was adopted to analyze the risk factors associated with CKD progression.

Results

There were eventually 240 patients (42.25%) receiving renal substitutive therapy during a mean follow-up of 2.25 years. Kaplan-Meier analysis showed that lower counts of CD3

CD4

and CD8

T cells were independently associated with higher occurrence of the renal endpoint events. Cox regression model suggested that the low-level groups of the above 3 kinds of T cells had significantly higher risks in progression into the endpoint events (

=1.575

1.511

1.583). After multivariable adjustment

the risk of the endpoint events remained increased in patients from the low-level group (

=1.803

1.945

2.010).

Conclusion

The reduction of CD3

CD4

and CD8

T cells in peripheral blood is closely related to the occurrence of renal substitutive therapy

which might be used as a predictive factor of renal outcome for CKD patients at pre-dialysis stage 3~5.

关键词

Keywords

references

MURPHY D MCCULLOCH C E LIN F Trends in prevalence of chronic kidney disease in the United States Ann Intern Med 2016 165 7 473 481 10.7326/m16-0273 MURPHY D, MCCULLOCH C E, LIN F, et al . Trends in prevalence of chronic kidney disease in the United States[J ] . Ann Intern Med, 2016, 165(7): 473-481. DOI: 10.7326/m16-0273.

ZHANG L X WANG F WANG L Prevalence of chronic kidney disease in China: a cross-sectional survey Lancet 2012 379 9818 815 822 10.1016/S0140-6736(12)60033-6 ZHANG L X, WANG F, WANG L, et al . Prevalence of chronic kidney disease in China: a cross-sectional survey[J ] . Lancet, 2012, 379(9818): 815-822. DOI: 10.1016/S0140-6736(12)60033-6.

TOWNSEND R R ANDERSON A H CHIRINOS J A Association of pulse wave velocity with chronic kidney disease progression and mortality: findings from the CRIC study (chronic renal insufficiency cohort) Hypertens Dallas Tex 2018 71 6 1101 1107 10.1161/HYPERTENSIONAHA.117.10648 TOWNSEND R R, ANDERSON A H, CHIRINOS J A, et al . Association of pulse wave velocity with chronic kidney disease progression and mortality: findings from the CRIC study (chronic renal insufficiency cohort)[J ] . Hypertens Dallas Tex, 2018, 71(6): 1101-1107. DOI: 10.1161/HYPERTENSIONAHA.117.10648.

VAZIRI N D Oxidative stress in uremia: nature, mechanisms, and potential consequences Semin Nephrol 2004 24 5 469 473 10.1016/j.semnephrol.2004.06.026 VAZIRI N D. Oxidative stress in uremia: nature, mechanisms, and potential consequences[J]. Semin Nephrol, 2004, 24(5): 469-473. DOI: 10.1016/j.semnephrol.2004.06.026.

BADIOU S CRISTOL J P JAUSSENT I Fine-tuning of the prediction of mortality in hemodialysis patients by use of cytokine proteomic determination Clin J Am Soc Nephrol 2008 3 2 423 430 http://europepmc.org/articles/PMC2390945/ BADIOU S, CRISTOL J P, JAUSSENT I, et al . Fine-tuning of the prediction of mortality in hemodialysis patients by use of cytokine proteomic determination[J ] . Clin J Am Soc Nephrol, 2008, 3(2): 423-430.

CARRERO J J STENVINKEL P Inflammation in end-stage renal disease-what have we learned in 10 years? Semin Dial 2010 23 5 498 509 10.1111/j.1525-139x.2010.00784.x CARRERO J J, STENVINKEL P. Inflammation in end-stage renal disease-what have we learned in 10 years?[J]. Semin Dial, 2010, 23(5): 498-509. DOI: 10.1111/j.1525-139x.2010.00784.x.

NOH J Y SONG J Y CHOI W S Immunogenicity of trivalent influenza vaccines in patients with chronic kidney disease undergoing hemodialysis: MF59-adjuvanted versus non-adjuvanted vaccines Hum Vaccines Immunother 2016 12 11 2902 2908 10.1080/21645515.2016.1191717 NOH J Y, SONG J Y, CHOI W S, et al . Immunogenicity of trivalent influenza vaccines in patients with chronic kidney disease undergoing hemodialysis: MF59-adjuvanted versus non-adjuvanted vaccines[J ] . Hum Vaccines Immunother, 2016, 12(11): 2902-2908. DOI: 10.1080/21645515.2016.1191717.

SALLUSTIO F SERINO G COX S N Aberrantly methylated DNA regions lead to low activation of CD4+ T-cells in IgA nephropathy Clin Sci Lond Engl 2016 130 9 733 746 10.1042/CS20150711 SALLUSTIO F, SERINO G, COX S N, et al . Aberrantly methylated DNA regions lead to low activation of CD4+ T-cells in IgA nephropathy[J ] . Clin Sci Lond Engl, 2016, 130(9): 733-746. DOI: 10.1042/CS20150711.

BETJES M G H LITJENS N H R Chronic kidney disease and premature ageing of the adaptive immune response Curr Urol Rep 2015 16 1 471 10.1007/s11934-014-0471-9 BETJES M G H, LITJENS N H R. Chronic kidney disease and premature ageing of the adaptive immune response[J]. Curr Urol Rep, 2015, 16(1): 471. DOI: 10.1007/s11934-014-0471-9.

HU Z L ZOU Q SU B Regulation of T cell immunity by cellular metabolism Front Med 2018 12 4 463 472 10.1007/s11684-018-0668-2 HU Z L, ZOU Q, SU B. Regulation of T cell immunity by cellular metabolism[J]. Front Med, 2018, 12(4): 463-472. DOI: 10.1007/s11684-018-0668-2.

谭政龚非力 T细胞功能亚群生命科学 2010 22 6 499 505 谭政, 龚非力. T细胞功能亚群[J]. 生命科学, 2010, 22(6): 499-505.

TAN Z GONG F L The functional subsets of T cells Chin Bull Life Sci 2010 22 6 499 505 TAN Z, GONG F L. The functional subsets of T cells[J]. Chin Bull Life Sci, 2010, 22(6): 499-505.

MEIJERS R W LITJENS N H DE WIT E A Uremia causes premature ageing of the T cell compartment in end-stage renal disease patients Immun Ageing 2012 9 19 10.1186/1742-4933-9-19 MEIJERS R W, LITJENS N H, DE WIT E A, et al . Uremia causes premature ageing of the T cell compartment in end-stage renal disease patients[J ] . Immun Ageing, 2012, 9: 19. DOI: 10.1186/1742-4933-9-19.

魏媛媛祝小东张莉终末期肾脏病患者与成年健康个体免疫功能的比较中国血液净化 2017 16 5 318 321, 339 魏媛媛, 祝小东, 张莉, 等. 终末期肾脏病患者与成年健康个体免疫功能的比较[J]. 中国血液净化, 2017, 16(5): 318-321, 339.

WEI Y Y ZHU X D ZHANG L Comparison of immune function between end-stage renal disease patients and healthy adults Chin J Blood Purif 2017 16 5 318 321, 339 WEI Y Y, ZHU X D, ZHANG L, et al . Comparison of immune function between end-stage renal disease patients and healthy adults[J ] . Chin J Blood Purif, 2017, 16(5): 318-321, 339.

黄迪吴锋姚东升轻、中度蛋白尿的慢性肾衰竭患者CD4+T、CD8+T、CD4+/CD8+的变化中国中西医结合肾病杂志 2017 18 2 119 122 黄迪, 吴锋, 姚东升, 等. 轻、中度蛋白尿的慢性肾衰竭患者CD4+T、CD8+T、CD4+/CD8+的变化[J]. 中国中西医结合肾病杂志, 2017, 18(2): 119-122.

HUANG D WU F YAO D S The changes of CD4 T, CD8+ T and CD4/CD8+ in chronic renal failure patients with mild to moderate proteinuria Chin J Integr Tradit West Nephrol 2017 18 2 119 122 HUANG D, WU F, YAO D S, et al . The changes of CD4 T, CD8+ T and CD4/CD8+ in chronic renal failure patients with mild to moderate proteinuria[J ] . Chin J Integr Tradit West Nephrol, 2017, 18(2): 119-122.

BASILE C LOMONTE C VERNAGLIONE L The relationship between the flow of arteriovenous fistula and cardiac output in haemodialysis patients Nephrol Dial Transplant 2007 23 1 282 287 10.1093/ndt/gfm549 BASILE C, LOMONTE C, VERNAGLIONE L, et al . The relationship between the flow of arteriovenous fistula and cardiac output in haemodialysis patients[J ] . Nephrol Dial Transplant, 2007, 23(1): 282-287. DOI: 10.1093/ndt/gfm549.

DESCAMPS-LATSCHA B HERBELIN A NGUYEN A T Dysregulation of the immune system in chronic uremic and hemodialysed patients Press Med Paris France 1995 24 8 405 410 http://www.ncbi.nlm.nih.gov/pubmed/7899421 DESCAMPS-LATSCHA B, HERBELIN A, NGUYEN A T, et al . Dysregulation of the immune system in chronic uremic and hemodialysed patients[J ] . Press Med Paris France, 1995, 24(8): 405-410.

LIBBY P RIDKER P M HANSSON G K Progress and challenges in translating the biology of atherosclerosis Nature 2011 473 7347 317 325 10.1038/nature10146 LIBBY P, RIDKER P M, HANSSON G K. Progress and challenges in translating the biology of atherosclerosis[J]. Nature, 2011, 473(7347): 317-325. DOI: 10.1038/nature10146.

VAN RIEMSDIJK I C BAAN C C LOONEN E H M Patients on chronic hemodialysis have no intrinsic lymphocyte defect upon stimulation with interleukin-2, interleukin-15 or tumor necrosis factor-alpha Blood Purif 2003 21 2 158 162 10.1159/000069154 VAN RIEMSDIJK I C, BAAN C C, LOONEN E H M, et al . Patients on chronic hemodialysis have no intrinsic lymphocyte defect upon stimulation with interleukin-2, interleukin-15 or tumor necrosis factor-alpha[J ] . Blood Purif, 2003, 21(2): 158-162. DOI: 10.1159/000069154.

ALVAREZ-LARA M A CARRACEDO J RAMÍREZ R The imbalance in the ratio of Th1 and Th2 helper lymphocytes in uraemia is mediated by an increased apoptosis of Th1 subset Nephrol Dial Transplant 2004 19 12 3084 3090 10.1093/ndt/gfh382 ALVAREZ-LARA M A, CARRACEDO J, RAMÍREZ R, et al . The imbalance in the ratio of Th1 and Th2 helper lymphocytes in uraemia is mediated by an increased apoptosis of Th1 subset[J ] . Nephrol Dial Transplant, 2004, 19(12): 3084-3090. DOI: 10.1093/ndt/gfh382.

LIN F J JIANG G R SHAN J P Imbalance of regulatory T cells to Th17 cells in IgA nephropathy Scand J Clin Lab Investig 2012 72 3 221 229 10.3109/00365513.2011.652158 LIN F J, JIANG G R, SHAN J P, et al . Imbalance of regulatory T cells to Th17 cells in IgA nephropathy[J ] . Scand J Clin Lab Investig, 2012, 72(3): 221-229. DOI: 10.3109/00365513.2011.652158.

REDDAN D N KLASSEN P S SZCZECH L A White blood cells as a novel mortality predictor in haemodialysis patients Nephrol Dial Transplant 2003 18 6 1167 1173 10.1093/ndt/gfg066 REDDAN D N, KLASSEN P S, SZCZECH L A, et al . White blood cells as a novel mortality predictor in haemodialysis patients[J ] . Nephrol Dial Transplant, 2003, 18(6): 1167-1173. DOI: 10.1093/ndt/gfg066.

HENDRIKX T K VAN GURP E A F J MOL W M End-stage renal failure and regulatory activities of CD4+CD25bright+FoxP3+ T-cells Nephrol Dial Transplant 2009 24 6 1969 1978 10.1093/ndt/gfp005 HENDRIKX T K, VAN GURP E A F J, MOL W M, et al . End-stage renal failure and regulatory activities of CD4+CD25bright+FoxP3+ T-cells[J ] . Nephrol Dial Transplant, 2009, 24(6): 1969-1978. DOI: 10.1093/ndt/gfp005.

FATHI F ATAPOUR A ESKANDARI N Regulatory T-cells and their impacts on cytokine profile of end-stage renal disease patients suffering from systemic lupus erythematosus Int J Immunopathol Pharmacol 2019 33 205873841986323 10.1177/2058738419863238 FATHI F, ATAPOUR A, ESKANDARI N, et al . Regulatory T-cells and their impacts on cytokine profile of end-stage renal disease patients suffering from systemic lupus erythematosus[J ] . Int J Immunopathol Pharmacol, 2019, 33: 205873841986323. DOI: 10.1177/2058738419863238.

TIAN N PENMAN A D MANNING R D Jr Association between circulating specific leukocyte types and incident chronic kidney disease: the Atherosclerosis Risk in Communities (ARIC) study J Am Soc Hypertens 2012 6 2 100 108 10.1016/j.jash.2011.10.001 TIAN N, PENMAN A D, MANNING R D Jr, et al . Association between circulating specific leukocyte types and incident chronic kidney disease: the Atherosclerosis Risk in Communities (ARIC) study[J ] . J Am Soc Hypertens, 2012, 6(2): 100-108. DOI: 10.1016/j.jash.2011.10.001.

郑鑫陈熠邓跃毅慢性肾衰竭CKD3~4期患者与体内免疫细胞的关系国际泌尿系统杂志 2019 39 5 885 888 10.3760/cma.j.issn.1673-4416.2019.05.032 郑鑫, 陈熠, 邓跃毅. 慢性肾衰竭CKD3~4期患者与体内免疫细胞的关系[J]. 国际泌尿系统杂志, 2019, 39(5): 885-888. DOI: 10.3760/cma.j.issn.1673-4416.2019.05.032.

ZHENG X CHEN Y DENG Y Y The relationship between CKD 3-4 patients with chronic renal failure and immune cells in patients Inter J Urol Nephrol 2019 39 5 885 888 10.3760/cma.j.issn.1673-4416.2019.05.032 ZHENG X, CHEN Y, DENG Y Y. The relationship between CKD 3-4 patients with chronic renal failure and immune cells in patients[J]. Inter J Urol Nephrol, 2019, 39(5): 885-888. DOI: 10.3760/cma.j.issn.1673-4416.2019.05.032.

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