CAPD患者におけるRecombinant Human Erythropoietin投与前後のリンパ球サブセットと免疫グロブリン産生能の変化

抄録

Recombinant human erythropoietin(r-HuEPO) is recognized to be effective in the treatment of anemia in patients on chronic dialysis. However, studies on the influence of r-HuEPO on the immune system are currently limited and inconsistent. In order to clarify the alteration of T and B lymphocyte subpopulations in patients on CAPD following administration of r-HuEPO, the changes in the expression of HLA-DR, IL2R and CD4/CD8 ratio in the peripheral blood of CAPD patients were evaluated using flow cytometry. In addition, the production of immunoglobulins in peripheral lymphocytes by enzyme immunoassays in 30 CAPD outpatients with anemia, who were treated with r-HuEPO in Tokai University Hospital, was also studied. The dose of r-HuEPO was 6, 000 IU in 13 patients in group I and 9, 000 IU in 17 patients in group II. The r-HuEPO was given subcutaneously once a week for up to 9 weeks. The level of hematocrit increasee significantly following treatment with r-HuEPO. The numbers of lymphocytes and their CD4/CD8 ratios in peripheral blood showed no significant changes after administration of r-HuEPO. The count of HLA-DR-positive T lymphocytes increased significantly and the count of IL2R-positive T lymphocytes decreased and normalized after administration of r-HuEPO. In comparison with healthy controls, basal formation of IgG, IgA and IgM was decreased significantly in PBMC from patients on CAPD. Following treatment with r-HuEPO, the production of IgG, IgA and 1gM in PBMC from CAPD patients did not show any significant changes. In conclusion, this study suggested that the administration of r-HuEPO altered T lymphocyte function and also corrected anemia in CAPD patients.