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CD4+CD28 Null T Cells as a Marker of Progression in Chronic Renal Disease Including Hemodialysis Patients and Its correlation with Systemic Inflammation and Atherosclerosis.
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EZZAT MOSTAFA MOHAMMED, MABROUK IBRAHIM M. ISMAIL, MANAR ABDELRAOOF RAFFAT, AMAL ZIDAN, AHMED MOHAMMED HUSSEIN MOHAMMED, NAFESA MOHAMMED KAMAL
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| Abstract:
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Background: one of the major risk factors to cardiovascular disease(CVD) is a Chronic kidney disease
CKD which considered a burden of global health and need high economic cost from health systems.
Chronic inflammation and endothelial dysfunction were a principle factors in the development of
atherosclerosis, which are observed in CKD and hemodialysis (HD) patients. CD4+CD28 null T cells, a
subtype of helper T cells, seem to be important in mediating some of the serious effects. CD4+CD28– T
cells can be recognized as typical Th1 cells which produce significant amounts of IFN-? and the cytotoxic
components, perforin and granzyme that are responsible for endothelial damage and play a role in the
pathogenesis of many inflammatory diseases.
Aim: To evaluate the peripheral circulatory level of CD4+ CD28 null T cells in different grads of CKD
including maintenance hemodialysis and its correlation to systemic inflammation and atherosclerosis in
CKD patients.
Subjects and Methods: Case control study were applied on 90 persons in Theodor Bilharz nephrology
unit and outpatient clinic, divided into three groups. group I: 30 fully healthy control subjects, group II:
included 30 CKD patients on maintenance HD more than six months and group III: included 30 CKD
patients (grade III A&B and grade IV) undergo conservative treatment. All subjects included in our study
were evaluated by CBC, LFT, KFT, blood electrolytes, CRP, carotid intimal-medial thickness (CIMT) and
CD4+CD28 null T cells were measured in the blood sample.
Results: CD4+CD28null T cells mean value in the HD group (9.47±.75) (P=0.00) was significant higher
than that of CKD group (4.67±3.06) which was higher but not significant than the control one (3.04±.79)
(p=0.4). Within the CKD group, level of this cells were high in CKD grade IV (4.81±0.88) more than grade IIIB
(4.70±1.46) which were a higher level than grade IIIA (4.49±0.79). There is a high positive significant
correlation between CD4++ CD28null T Cells and carotid intimal medial thickness (CIMT) (r=0.618)
(p<0.0001) & CRP in the studied groups (r=0.625) and (p <0.0001) and negative correlation with eGFR
(r=-0.837) (p <0.0001).
Conclusions: Peripheral circulatory increase in CD4 + CD28 null T cells in CKD patients and this
expansion elevated as CKD grades progress, this expansion was positively correlated to systemic
inflammation and atherosclerosis; supporting a role of inflammation and immunity in initiation and
progression of atherosclerosis. So CD4++ CD28null T cells may use as a marker of progression of
chronic renal disease as same as atherosclerotic cardiovascular disease. So we must have searched blood level of CD4+CD28- and treated early to avoid its hazards.
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| Keyword:
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CD4+ CD 28 null T cell, Chronic Kidney Diseases (CKD), Atherosclerosis, Inflammation, Cardiovascular disease, CIMT.
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| EOI:
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| DOI:
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https://doi.org/10.31838/ijpr/2021.13.02.327
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| Download:
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