Study On The Quantity And Activity Of Dendritic Cell Of Peripheral Blood In Patients With Chronic Renal Failure

ObjectiveTo demonstrate the cellular immune function, evaluate the influnce of peritoneal dialysis and hemodialysis on the immune status of patients with chronic renal failure (CRF) and establish the foundation for the development of immunotherapy on CRF, the quantity and activity of dendritic cell (DC) of peripheral blood in patients with CRF were counted and analysed in this experiment.MethodsForty-one patients with CRF and 23 healthy individuals were used in this study, According to the patients' condition and intervention, patients were divided into four groups: azotemia group and uremic group (CRF patients on conservative treatment), peritoneal dialysis group (PDG) (uremic patients on regular peritoneal dialysis), hemodialysis group (HDG) (uremic patients on regular hemodialysis).(1) The frequency of subsets of DC was detected by human Blood DC enumeration Kit.(2) The peripheral blood mononuclear cells (PBMCs) of T cell-depleted populations were incubated and induced into mature DCs in RPMI-1640 medium in the presence of cytokines GM-CSF, IL-4, TNF-a and 100ml.L(-1 ) of FBS for a total of 9 days in vitro experiment. The expressions of surface marker on DCs were detected by flow cytometry.(3) ELISA was used to detect the cytokine level of IL-12 in the supernatant produced by DCs on the 9th day.(4) The stimulatory capacity of DCs to T cell proliferation was evaluated by allogenic mixed lymphocyte reaction (AMLR).Results(1) Analysis of the quantity of subsets of DC: The quantities of DC and meyloiddendritic cell (MDC)l from azotemia group increased, while the quantities of DC and plasmacytoid dendritic cell (PDC) from uremic group decreased (P<0.05) ; the quantity of MDC1 from HDG significantly decreased, while PDC increased leading to the proportion of them inverse compared with healthy controls(P<0.01).(2) Analysis of phenotype of DC: Compared with healthy controls, the expression levels of phenotype markers on DC surface from uremic group significantly decreased (P<0.01); the expression levels of CD40, CD80,CD83 on DC surface from PDG decreased (PO.05); the expression levels of CDla,CDllc,CD40 on DC surface form HDG decreased(P<0.05),while that of CD 123 increased except for the normal expression levels of CD80,CD83.(3) Detection of IL-12: The production of IL-12 of DCs from uremic patients was decreased, so did in PDG and HDG patients, while that of DCs from azotemia patients was increased compared with healthy controls (P < 0.05).(4) AMLR: The stimulatory capacity of DCs to T cell proliferation from uremic patients and PDG patients significantly decreased, while that of DCs from azotemia patients significantly increased in AMLR (P<0.01). The stimulatory capacity of DCs to T cell proliferation from HDG patients was approach to normal compared with healthy control (P>0.05).ConclusionThe patients with CRF had the immature phenotype of DC that was defect in fuction and decreased in quantity. The quantity and activity of DC increased in azotemia stage but decreased in uremic stage; DC from PD patients had defective function, while ameliorated in quantity; The quantity of MDC from HD patients remain to be reduced but PDC increased leading to the proportion of them inverse, while they had normal function. Our results indicated that kidney replacement therapy could partly ameliorate the metabolism of DC.