Decreased Peripheral Naïve T Cell Number and Its Role in Predicting Cardiovascular and Infection Events in Hemodialysis Patients

Front Immunol. 2021 Mar 17:12:644627. doi: 10.3389/fimmu.2021.644627. eCollection 2021.

Abstract

Patients with end-stage renal disease (ESRD) are at high risk of morbidity and mortality from cardiovascular and infectious diseases, which have been found to be associated with a disturbed immune response. Accelerated T-cell senescence is prevalent in these patients and considered a significant factor contributing to increased risk of various morbidities. Nevertheless, few studies have explicated the relevance of T-cell senescence to these fatal morbidities in ESRD patients. In this study, we designed a longitudinal prospective study to evaluate the influence of T-cell senescence on cardiovascular events (CVEs) and infections in hemodialysis (HD) patients. Clinical outcomes of 404 patients who had been on HD treatment for at least 6 months were evaluated with respect to T-cell senescence determined using flow cytometry. We found that T-cell senescence was associated with systemic inflammation. High-sensitivity C-reactive protein was positively associated with decreased naïve T cell levels. Elevated tumor necrosis factor-α and interleukin 6 levels were significantly associated with lower central memory T cell and higher T effector memory CD45RA cell levels. Decreased CD4+ naïve T cell count was independently associated with CVEs, whereas decreased CD8+ naïve T cell count was independently associated with infection episodes in HD patients. In conclusion, HD patients exhibited accelerated T-cell senescence, which was positively related to inflammation. A reduction of naïve T cell could be a strong predictor of CVEs and infection episodes in HD patients.

Keywords: T-cell senescence; cardiovascular event; hemodialysis; infection; naïve T cells.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • CD4-Positive T-Lymphocytes* / immunology
  • CD4-Positive T-Lymphocytes* / metabolism
  • CD8-Positive T-Lymphocytes* / immunology
  • CD8-Positive T-Lymphocytes* / metabolism
  • Cardiovascular Diseases* / blood
  • Cardiovascular Diseases* / etiology
  • Cardiovascular Diseases* / immunology
  • Cellular Senescence / immunology*
  • Female
  • Humans
  • Infections* / blood
  • Infections* / etiology
  • Infections* / immunology
  • Kidney Failure, Chronic* / blood
  • Kidney Failure, Chronic* / complications
  • Kidney Failure, Chronic* / immunology
  • Kidney Failure, Chronic* / therapy
  • Lymphocyte Count
  • Male
  • Middle Aged
  • Renal Dialysis*