Influence of recombinant human erythropoietin and blood transfusions on the composition of lymphocyte populations in hemodialyzed patients

Abstract

The effects of recombinant human erythropoietin (rHuEpo) treatment and blood transfusions on the composition of lymphocyte populations in chronic renal failure patients undergoing maintenance hemodialysis treatment were examined. Immune cells were investigated in the peripheral blood of 122 hemodialysis patients using two-color flow cytometry analysis. For detection of lymphocyte surface markers, a panel of monoclonal antibodies reactive with the following molecules was used: CD3, CD4, CD8, B cell, CD16, CD56, T-cell receptor αβ heterodimer (TCR αβ), T-cell receptor γδ heterodimer (TCR γδ), and human leukocyte antigen (HLA)-DR. Hemodialysis patients who received rHuEpo treatment were found to have significantly lower percentages of CD3 + lymphocytes compared with untreated patients. rHuEpo administration was shown to affect mainly the subset of T cells bearing TCR αβ (TCR αβ +). A relative increase in the activated TCR αβ + subsets and a decrease in the nonactivated TCR αβ + subsets were observed in rHuEpo-treated individuals. The significantly elevated TCR αβ + and TCR γδ + subset activation indexes found in patients who received rHuEpo suggested a state of activation of the immune system. A history of blood transfusions was shown to be associated with a higher proportion of cytotoxic (CD8 +) T cells and a decrease in the helper-suppressor index. Blood transfusions had an effect on the T-cell receptor-bearing lymphocyte populations similar to that of rHuEpo administration. We conclude that both rHuEpo treatment and blood transfusions contribute to altered cellular immunity in end-stage renal disease.