Children with chronic renal failure have reduced numbers of memory B cells.
Reduced serum IgG and subclass levels have been demonstrated in children with chronic renal failure. To study possible causes of this reduction, we analysed B cell subset composition, T helper cell frequencies and immunoglobulin (Ig) production capacity in vitro in children with chronic renal failure, with or without dialysis treatment. B cell subsets were characterized by determining CD27, IgM, IgD and CD5 expression within the CD19(+) population. Intracellular expression of interferon (IFN)-gamma, interleukin (IL)-2 and IL-4 in PMA/ionomycin-stimulated peripheral blood mononuclear cells (PBMC) was used to evaluate T helper frequencies. The capacity of B cells to secrete Ig in vitro was determined by measuring IgG(1), IgG(2) and IgM in culture supernatants of anti-CD2/CD28 monoclonal antibody (MoAb)- or SAC/IL-2-stimulated PBMC. Memory B cell numbers (identified as percentage or absolute number of CD19(+) IgM-IgD- or CD19(+)CD27(+) lymphocytes) were lower in children treated with haemodialysis (HD), peritoneal dialysis (PD) and children with chronic renal failure before starting dialysis treatment (CRF) compared to healthy controls (HC) (P < 0.05). Compared with HC, CD5(+) (naive) B cells were reduced in HD-treated patients but not for PD or for children with chronic renal failure before starting dialysis treatment (CRF). No significant differences in CD4(+) T helper cell subsets were found between the groups. However, CRF children had a higher percentage of IFN-gamma producing CD8(+) T lymphocytes compared to HC (P = 0.02). Finally, IgG(1), IgG(2) and IgM production in vitro was similar in the four groups. In conclusion, significantly lower numbers of memory type B cells were found in children with chronic renal failure compared to healthy controls. This reduction may contribute to the low Ig levels found in these children.
Emma Children's Hospital, Department of Experimental Immunology, Academic Medical Center, Amsterdam, The Netherlands. A.H.Bouts@amc.uva.nl
A H M
AH
Bouts
J C
JC
Davin
R T
RT
Krediet
L A H
LA
Monnens
J
J
Nauta
C H
CH
Schröder
R A W
RA
van Lier
T A
TA
Out
D000293:Adolescent; D001402:B-Lymphocytes / Q000276:immunology*; D015415:Biomarkers / Q000032:analysis; D018956:CD5 Antigens / Q000032:analysis; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007072:Immunoglobulin D / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D007156:Immunologic Memory; D007676:Kidney Failure, Chronic / Q000276:immunology* / Q000628:therapy; D018655:Lymphocyte Count; D010530:Peritoneal Dialysis; D006435:Renal Dialysis; D018127:Tumor Necrosis Factor Receptor Superfamily, Member 7 / Q000032:analysis
D015415:Biomarkers; D018956:CD5 Antigens; D007072:Immunoglobulin D; D007075:Immunoglobulin M; D018127:Tumor Necrosis Factor Receptor Superfamily, Member 7