CD28null and Regulatory T Cells Are Substantially Disrupted in Patients with End-Stage Renal Disease Due to Diabetes Mellitus

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Abstract

End-stage renal disease (ESRD) is associated with alterations in T-cell immunity, including increased CD28null and reduced regulatory T cells (Tregs). However, whether immune disturbances are due to ESRD or primary disease is not yet clear. As diabetes mellitus is the leading cause of ESRD, we evaluated its impact on the immune profile of ESRD patients.

T cells are one of the important white blood cells of the immune system and play a central role in the adaptive immune response. T cells can be easily distinguished from other lymphocytes by the presence of a T-cell receptor (TCR) on their cell surface. Different populations of T-cells were measured in 30 predialysis patients,who had diabetes, 30 patients without diabetes and 25 healthy controls  Measurements were repeated after 6 months on hemodialysis (HD) or peritoneal dialysis (CAPD). The concentration of T-cells in all the three groups differed. Patients with diabetes had increased number of T-cells, which means higher immune response.  After 6 months on hemodialisis  showed a significant further increase in immune cells in diabetes patients.

Conclusions: Diabetes mellitus affects T-cell subtypes even at predialysis stage, though changes become more prominent after commencement of hemodialysis. Regular checkups on T-cells state can be useful in preventive diagnostics

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