Abstract: SA-PO936
TH1 and TH2 Immune Response to External Stimuli in Patients on Peritoneal Dialysis
Session Information
- Peritoneal Dialysis: Inflammation, Peritoneal Transport
November 09, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 703 Dialysis: Peritoneal Dialysis
Authors
- Rizwan, Arshi, All India Institute of Medical Sciences, New Delhi, Delhi, India
- Mahajan, Sandeep, All India Institute of Medical Sciences, New Delhi, DELHI, India
Background
Infections remain leading complication in patients undergoing peritoneal dialysis (PD). Peripheral blood mononuclear cells (PBMCs) provide first-line defense against invading pathogens. Cytokines are central host molecules involved in modulating the host environment during inflammatory conditions. Though few studies have demonstrated expression of cytokines from stimulated PBMCs in hemodialysis patients, no study has systematically looked at their function among patients on PD. We evaluated cytokines expression in PBMCs stimulated by various external stimuli in patients on peritoneal dialysis (PD group), patients having chronic kidney disease stage 5 not on dialysis (CKD group) and compared it with those of healthy controls.
Methods
PBMCs were isolated as per standard procedure and were seeded in tissue culture plates in a concentration of 1 × 106 cells/well. They were stimulated with phytohaemagglutinin (PHA, a potent T- and B-cell mitogen), peritoneal dialysate effluent (DE) and fresh peritoneal dialysis fluid (PDF; Baxter, India). To evaluate the cytokine productions by stimulated PBMCs, ELISA was performed.
Results
In CAPD patients the expression of TH1 (IL- 1β, TNFα, IFNg), TH2(IL- 10, IL-4)cytokines from PBMCs stimulated by dialysis effluent was significantly lower, compared with CKD5 (P=.001, P=.001, P=.001, P=.001, andP=.001P=.004, respectively) and healthy controls (P=.001, P=.001, P=.001, P=.001, and P=.001, P=.001, respectively). Th1 (TNF-α, IFN-g, IL-1β,), Th2 (IL-4) and regulatory (IL-10) cytokines were significantly lower in PD patients when compared with healthy controls stimulated by dialysis effluent. PBMCs of PD patients stimulated by fresh fluid expressed reduced Th1 cytokines than those dialysis effluents. Cytokine immune response was significantly reduced when stimulated with PHA and dialysis effluent in PD patients as compared CKD5 patients and controls. Cytokines values were significantly more with PHA followed by DE and PDF respectively in each group.
Conclusion
Polarization of helper T-cells in response to mitogenic stimulation was blunted in CAPD patients compared with controls and CKD 5 resulting in a significant decrease in both Th1 cells and Th2 cells. These studies suggest that the clinical presentation of the dialysis was influenced by the type of cytokine (Th1 and Th2) production.
Funding
- Government Support - Non-U.S.