Abstract
Abstract Background and Aims Reduced expression of CD28 molecule on CD4+ and CD8+ cells is a potential marker of senescence and has also been described in end stage renal disease (ESRD). Aim of the present study was to evaluate changes of CD28 expression on CD4+ and CD8+ cells in ESRD patients, and to assess possible effects of ageing and HD. Method Flow cytometric analysis was performed in 96 patients [M/F 54/42 Age 56.6(18-81)yrs] on HD to evaluate the expression of CD28 antigen on CD4+ and CD8+ cells. Proportions and absolute numbers of CD4+CD28null and CD8+CD28null cells were estimated, and results were correlated to patients age and time on HD. Patients with malignant or systemic disease were excluded, as those with inadequate HD (KT/V<1,2), or recent (<3months) infection. Results were compared to those of 27 healthy controls, similar age, sex, and race. Results HD patients had significantly reduced lymphocyte count (p<0.001), percentage and total count of CD3+ cells (p=0.04, p<0.0001, respectively) and CD4+ cells (p=0.005, p<0.001, respectively). Percentage of CD4+CD28null and CD8+CD28null cells were both increased in patients compared to controls (p=0.009, p=0.01, respectively). However, although changes in CD8CD28null cells were evident early, even in <2yrs, similar changes in CD4CD28null cells, appeared only after ≥2yrs on HD, (p=0.004). Age of the patients had significant correlation with CD8+CD28null cells (r=0.4, p=0.001). In the older groups (>40yrs) patients had significantly increased CD3+CD28null, CD4+CD28null and CD8+CD28null cells, compared to older controls (p=0.002, p=0.003, p=0.01, respectively). Conclusion CD28 expression is significantly reduced on CD4+ and CD8+ cells in HD patients. CD8+CD28null expression is significantly affected early, both by age and HD, while CD28 expression on CD4+ seems to be more stable, as CD4+CD28null cells increase in older patients, after long time on HD.
Published Version
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