Frequency of Th1 and Th17 Cells and IL‐17A Levels in Peripheral Blood and Peritoneal Effluent in a Cohort of Patients Undergoing Peritoneal Dialysis: A Cross‐Sectional Study
DOI:
https://doi.org/10.71749/pkj.40Keywords:
Peritoneal Dialysis, Th1 cells, Th17 cells, Interleukin-17, Renal Insufficiency, ChronicAbstract
Introduction: Chronic kidney disease is characterized by an immune imbalance. In peritoneal dialysis (PD), chronic expo‐ sure to high‐load glucose solutions may further aggravate such disturbances. Among these inflammatory mediators, T helper 1 (Th1) and Th17 cells as well as interleukin 17A (IL‐17A) seem to stand out. We aimed to quantify the frequency of Th1 and Th17 cell subsets and IL‐17A levels in blood and peritoneal effluent (PE), looking at the peritoneal membrane (PM) and PD prescription characteristics as potential immune modulators.Methods: Cross‐sectional study of 26 PD patients and 10 healthy, age and sex‐matched controls. Cell frequencies were determined by flow cytometry and IL‐17A concentration was measured by enzyme‐linked immunosorbent assay. PD patients were evaluated according to PD prescription and PM characteristics.
Results: Blood Th1 cells’ frequency was decreased in PD patients (p=0.001) and icodextrin users had a lower frequency of Th17 cells, when compared to healthy controls (p=0.030). The immune cell profile of PE mimicked that of blood, except for Th1 cells, whose frequency was higher in PE (p<0.001). IL‐17A concentration was higher in PE (p=0.039), without a concomitant increase in Th17 cells. In subgroup analysis, increased IL‐17A was documented in PE of patients in automated PD (p=0.028) and those without a previous history of peritonitis (p=0.022).
Conclusion: Long‐term PD seems to modify both circulating and peritoneal immune cell profiles. The distribution of immune cells in PE closely mirrored that of blood, except for Th1 cells. Increased IL‐17A levels in PE may explain the deleterious long‐term effects of PD in the PM.
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Copyright (c) 2024 João Grilo, Catarina Reis Santos, Joana Coutinho, Inês Barreto, Raquel Chorão, Rui Alves Filipe, Andreia Monteiro, Mafalda Fonseca, Ernesto Rocha (Author)
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