Increased interleukin-17 producing effector memory T cells in the end-stage renal disease patients

Patients with end-stage renal disease (ESRD) exhibit immune dysregulation, but the precise immunological profile and the effect of hemodialysis (HD) on it has not been investigated fully. Thirty-eight ESRD patients (22 on HD and 16 in pre-dialysis) and 24 healthy volunteers were included. We compared the T cell immune profiles as in these patients. Among the effector T cell subset, the percentages of Th17 and Th2 cells were significantly higher in the ESRD group than in the healthy controls (P<0.05). The percentage of Th1 cells did not differ significantly between these groups. The percentages of Th1, Th2 and Th17 cells did not differ significantly (P>0.05) between the two subgroups within the ESRD group. The CCR4 ^-CCR6 ⁺/CD4 ⁺ T cell percentage was also significantly higher in the ESRD group. The naïve T cell (T _naïve) percentage was significantly lower in the ESRD group, and the difference between patients and controls was greater in the pre-dialysis patients than in the HD patients (P<0.05, for each comparison). By contrast, the percentages of central memory T cells (T _CM) and effector memory T (T _EM) cells were significantly higher in the ESRD group. Interleukin-17 production by T _EM cells was significantly higher in the ESRD group. The severity of uremia was related negatively to the T _naïve cell percentage but positively to the T _CM and T _EM cell percentages. The percentages of T _EM and CD45RA ⁺ T effector memory subsets of CD8 ⁺ T cells were significantly higher in the ESRD group (P<0.05). The result of this study showed significantly altered T cell-associated immunity and that it could not be corrected with hemodialysis.