Abstract
The effect of hemodialysis on cell-mediated immunity was investigated in 30 hemodialysis patients. Several parameters of cell-mediated immunity, such as natural killer (NK) activity, antibody dependent cell-mediated cytotoxicity (ADCC), concanavalin A-induced suppressor T cell function (Con A-Ts), autologous mixed lymphocyte reaction (AMLR) and analysis of lymphocyte subsets using monoclonal antibodies by fluorescence-activated cell sorter, were assessed in these patients.
The NK activities of NK cells and ADCC were significantly decreased in hemodialysis patients compared with normal subjects. Moreover, AMLR of whole T cells, Tγ cells and T non γ cells were significantly decreased in hemodialysis patients compared with normal subiects. However, the Con A-Ts in hemodialysis patients was normal.
Peripheral lymhocyte subsets were measured using monoclonal antibodies (OKT and Leu series). The percentage of Leu3a, OKM1, Leu11a, OKla1 and HLA-DR positive cells were significantly higher in the hemodialysis patients, whereas the percentage of Leu2a positive cells was significantly decreased. In contrast, there was not such a big difference in the percentage of OKT3, OKT4, OKT8, Leu4 and Leu7 positive cells between the two groups.
We also studied the influence of blood transfusion on cellular immunity in hemodialysis patients. A marked decrease in AMLR between Tγ and non T cells was observed in blood transfused patients.
Concerning other cellular immunological functions, no abnormal findings were observed in blood transfused patients.
These results indicate that hemodialysis patients may have defects in immunological surveillance for neoplasma, defense against viral infections and the self-recognition mechanism.
