Immunologic disturbances and levels of parathyroid hormone in uremic patients in replacement dialysis therapy.
We studied the changes in cellular immunity in patients in replacement dialysis therapy (RDT) and examined the relationship between T-lymphocyte function and plasma levels of parathyroid hormone (PTH). In a preliminary study we found that increased plasma levels of PTH were associated with a decrease of T-lymphocytes and CD4, an increase in CD8 and a reduction in the ratio of CD4 to CD8. In the present study we examined the relationship between plasma levels of PTH, interleukin 2 receptors (IL-2R) and soluble human CD8 (S-CD8). We studied 54 patients divided into two groups: 26 patients with normal levels of PTH and 28 patients with increased levels of PTH. We found a significant reduction in total T-lymphocytes in both groups as compared to controls, with an inverse correlation between total T-lymphocytes and plasma PTH in the second group (R = -0.52). There was an increase in IL-2R in the group II as compared to the controls and also in the total population of uremic patients with a linear correlation between levels of IL-2R and PTH (R = 0.6). The levels of S-CD8 showed a significant increase in both groups with a linear correlation between levels of SC-D8 and PTH (R = 0.63). No specific differences were seen between patients treated with and without 1,25-dihydroxyvitamin D3. The elevated levels of PTH affect the lymphocyte function and are associated with change in cellular immunity with reduction in total number of T cells, and increases in levels of CD8, S-CD8 and IL-2R.
Department of Nephrology, Hospital of Lucca, Italy.
D
D
Angelini
A
A
Carlini
L
L
Mazzotta
E
E
Mei
R
R
Grassi
R
R
Giusti
M
M
Neri
I
I
Fiorini
A
A
Antonelli
D000328:Adult; D000368:Aged; D016827:CD8 Antigens / Q000032:analysis; D018414:CD8-Positive T-Lymphocytes; D005260:Female; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000276:immunology*; D007111:Immunity, Cellular / Q000276:immunology; D007124:Immunoenzyme Techniques; D018655:Lymphocyte Count; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood*; D015375:Receptors, Interleukin-2 / Q000032:analysis; D006435:Renal Dialysis; D016176:T-Lymphocyte Subsets; D013601:T-Lymphocytes / Q000276:immunology*; D014511:Uremia / Q000097:blood / Q000276:immunology* / Q000628:therapy
D016827:CD8 Antigens; D010281:Parathyroid Hormone; D015375:Receptors, Interleukin-2