title: Chronic inflammation and hemodialysis reduce immune competence of peripheral blood leukocytes in end-stage renal failure patients.
abstract: Immunoincompetence is a profound problem in end-stage renal failure patients undergoing hemodialysis, and chronic inflammation with altered serum levels of inflammation markers has been reported. Gene expression patterns have had little relevance for leukocyte research so far because of limitations in transcript levels and stability. Using a new stimulation system we induced the expression of immune-relevant transcripts in whole blood preparations ex vivo and stabilized transcript levels by preventing RNA degradation and uncontrolled gene induction. Using quantitative real-time PCR we could show that basal TGF-beta mRNA expression is about 2-fold decreased in end-stage renal failure patients, while expression of TNF-alpha becomes 2-fold increased, further doubling during hemodialysis. By short term stimulation with phytohemagglutinin (PHA) for 2 h we tested for the immune competence of peripheral blood leukocytes and demonstrated that hemodialysis decreases TNF-alpha-mediated immune responsiveness more than 3-fold. This study shows by induction and stabilization of immune-relevant transcripts that chronic inflammation and hemodialysis are crucial factors for disturbed immune competence of end-stage renal failure patients.
authors.affiliation: German Diabetes Clinic, German Diabetes Center, Leibniz Institute at the Heinrich-Heine-University Düsseldorf, Auf'm Hennekamp 65, 40225 Düsseldorf, Germany.
authors.forename: Kerstin
authors.initials: K
authors.lastname: Knerr
authors.forename: Reiner
authors.initials: R
authors.lastname: Füth
authors.forename: Patrick
authors.initials: P
authors.lastname: Hemsen
authors.forename: Walburga
authors.initials: W
authors.lastname: Mohné
authors.forename: Antonia
authors.initials: A
authors.lastname: Heinig
authors.forename: Werner
authors.initials: W
authors.lastname: Kleophas
authors.forename: Werner A
authors.initials: WA
authors.lastname: Scherbaum
authors.forename: Stephan
authors.initials: S
authors.lastname: Martin
mesh_terms: D000328:Adult; D015415:Biomarkers; D005260:Female; D006801:Humans; D007121:Immunocompetence / Q000276:immunology*; D007249:Inflammation / Q000097:blood / Q000276:immunology* / Q000473:pathology*; D007676:Kidney Failure, Chronic / Q000276:immunology* / Q000628:therapy; D007962:Leukocytes / Q000276:immunology* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D016212:Transforming Growth Factor beta / Q000097:blood / Q000235:genetics; D014409:Tumor Necrosis Factor-alpha / Q000235:genetics
chemical_list: D015415:Biomarkers; D016212:Transforming Growth Factor beta; D014409:Tumor Necrosis Factor-alpha