Non-responsiveness to hepatitis B vaccination in haemodialysis patients: association with impaired TCR/CD3 antigen receptor expression regulating co-stimulatory processes in antigen presentation and recognition.
The study was undertaken to evaluate the relationship between non-responsiveness to hepatitis B (HBV) vaccination in haemodialysed patients and HBs antigen (Ag) presentation and recognition depending on TCR/CD3 receptors expression. We have found that the cause of the blunted response to HBV vaccination is multifactorial and seems to be associated with the following: (1) A reduced number of TCR/CD3 antigen receptor complexes on freshly isolated uraemic CD4 T cells, especially in non-responders. (2) The blunted proliferative response of uraemic CD4 T cells isolated from non-responders and stimulated for 6 days by autologous monocytes presenting HBsAg was associated with the decreased density of the TCR/CD3 receptors. (3) Moreover, in uraemic non-responders the expression of adhesion and accessory molecules on monocytes (intercellular adhesion molecule-1/ICAM-1, HLA-DR/Ia/) was significantly decreased following the culture with autologous monocytes serving as HBsAg-presenting cells. CD4 molecules and lymphocyte function antigen-1 beta/LFA-1 beta/ on helper-inducer T cells were increased before and after the culture. (4) These findings were also associated with a diminished binding capacity of IL-1 beta and IL-6 to their receptors on helper-inducer T cells. (5) IL-2, IFN-gamma and IL-4 production was decreased in uraemic non-responders, especially after 72 h of the culture. (6) Inhibited proliferation of helper-inducer T cells in uraemic non-responders was only partially reversible in the presence of exogenous IL-1 beta, IL-6, IL-2 and IFN-gamma. (7) HLA typing of uraemic non-responders was associated with extended haplotype: HLA A1,B8,DR3,DR7,DQ2.
Stachowski
J
J
Department of Nephrology, University of Cologne, Germany.
Pollok
M
M
Barth
C
C
Maciejewski
J
J
Baldamus
C A
CA
D000328:Adult; D017951:Antigen Presentation; D017252:CD3 Complex / Q000378:metabolism*; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology; D015815:Cell Adhesion Molecules / Q000378:metabolism; D016207:Cytokines / Q000096:biosynthesis; D005260:Female; D006680:HLA Antigens; D017325:Hepatitis B Vaccines / Q000276:immunology*; D006801:Humans; D007108:Immune Tolerance; D018799:Intercellular Adhesion Molecule-1; D008213:Lymphocyte Activation; D016169:Lymphocyte Function-Associated Antigen-1 / Q000378:metabolism; D008222:Lymphokines / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D011971:Receptors, Immunologic / Q000378:metabolism; D006435:Renal Dialysis / Q000009:adverse effects*; D013601:T-Lymphocytes / Q000276:immunology; D014511:Uremia / Q000276:immunology / Q000628:therapy
D017252:CD3 Complex; D015815:Cell Adhesion Molecules; D016207:Cytokines; D006680:HLA Antigens; D017325:Hepatitis B Vaccines; D016169:Lymphocyte Function-Associated Antigen-1; D008222:Lymphokines; D011971:Receptors, Immunologic; D018799:Intercellular Adhesion Molecule-1