title: Role of T-regulatory cells in the response to hepatitis B vaccine in hemodialysis patients.
abstract: Human disease elicits a complex array of biological processes that results in long-term protective immunological memory to infectious agents. Chronic kidney disease is known to impair induction of sustained immunological memory to hepatitis B vaccine (HBVax) antigens. We asked the question: Does end-stage renal disease promote changes in subtypes of regulatory T (Treg) cells that correlate with diminished amnestic response to HBVax antigen compared to healthy controls? The study design and setting was a prospective observational cohort at a veterans affairs medical center. End-stage renal disease patients on hemodialysis (HD) were compared with individuals with self-reported normal kidney function. All subjects received HBVax. Peripheral blood was sampled for assessment for Treg cells pre and post vaccination. CD4+ FOXP3 Treg numbers were similar between HD and healthy subjects during a 14-day time period post vaccination. HD subjcts had lower anti-HBSag antibody than CON (control) subjects (330 ± 108.7 vs. 663.1 ± 129.7 IU/mL; P = 0.063). Hemodialysis subjects with resting Tregs higher than the median value in our cohort demonstrated a significantly lower change in HBsAB at 30 days post booster vaccination (P = 0.030). No such relationship was found for the activated Treg subset among HD subjects, or either subset among CON subsets. In our limited comparison study of 11 HD and 8 CON subjects, Treg subsets did not differ between the two groups; but differences in the suppressive Treg numbers in the HD group could explain the altered antibody response to HBVax and is worthy of further study.
authors.affiliation: Department of Medicine, Division of Nephrology, Stratton Veterans Affair Medical Center, Albany, New York, USA.|Department of Medicine, Albany Medical College, Albany, New York, USA.
authors.forename: Roy O
authors.initials: RO
authors.lastname: Mathew
authors.affiliation: Department of Medicine, Division of Nephrology, Stratton Veterans Affair Medical Center, Albany, New York, USA.|Division of Nephrology, Albany College of Pharmacy and Health Sciences, Albany, New York, USA.
authors.forename: Darius L
authors.initials: DL
authors.lastname: Mason
authors.affiliation: Biochemistry & Immunology Core Facility at Wadsworth Center, New York State Department of Health, Albany, New York, USA.
authors.forename: Renjie
authors.initials: R
authors.lastname: Song
authors.affiliation: Translational Medicine, Albany Medical College, Albany, New York, USA.
authors.forename: Tiffany
authors.initials: T
authors.lastname: Tryniszewski
authors.affiliation: Translational Medicine, Albany Medical College, Albany, New York, USA.
authors.forename: Jeffrey S
authors.initials: JS
authors.lastname: Kennedy
mesh_terms: D000368:Aged; D015331:Cohort Studies; D005260:Female; D017325:Hepatitis B Vaccines / Q000627:therapeutic use*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy*; D008297:Male; D011446:Prospective Studies; D006435:Renal Dialysis / Q000379:methods*; D050378:T-Lymphocytes, Regulatory / Q000378:metabolism*
chemical_list: D017325:Hepatitis B Vaccines
keywords: Regulatory T cells; end-stage renal disease; hepatitis B vaccine; immune dysfunction