The effect of subcutaneous recombinant human erythropoietin on immune functions in patients with chronic renal failure undergoing hemodialysis (CROSBI ID 91552)
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Lovčić, Vesna ; Mažuran, Renata ; Milutinović, Slobodan ; Bubić-Filipi, Ljubica ; Svoboda-Beusan, Ivna ; Jovičić, Aleksandra
engleski
The effect of subcutaneous recombinant human erythropoietin on immune functions in patients with chronic renal failure undergoing hemodialysis
7ib determine the influence of the recombinant human erythropoietin (r-HuEPO) on the immune system in patients on regular hem odialysis with the object of ascertaining its efficacy on anemia in chronic renal failure. 7Wenty-two dialysis patients with renal anemia were enrolled in an open-labelled hi-institutional trial. Inclusion criteria was hemoglobin less than 80 gIL, . r-HuEPO weekly dosage was 100-150 lU/kg administered sc. on 3 occasions, until hemoglobin reaches 105 gIL (average treatment period 9 weeks). The efficacy on the immune status was assessed in terms of enumerative and functional parameters in the patients blood. Blood samples were collected before hemodialysis session (a) initially before r-HuEPO treatment, (b) one week later ; (c) optionally after hemoglobin reached 105 gIL, (d) optionally during the main tenance therapy (average period 22 weeks). Lymphocyte subpopulations (naive and activated R Th, 7b and NK) were assayed by direct one- and two-colour immunofluorescence staining of whole blood using a panel of monoclonals to GD2, CD3, CD4, CD8, GD2O, HLA-DR, GD71, CD2S and CD 16, 56 surface molecules. A standard 51Cr release assay of NK activity using K562 was performed. Cytokines were determined by bioassay: interferon (JFN), tumor necrosis factor (TNF), orimmunoassay: interleukin-6 (IL-6), soluble receptors for IL-6 (sIL-6R). r-HuEPO significantlyreduced the percentage of CD8~ cytotoxic Tlymphocytes, however that effect was reversible. r-HuEPO was ineffective against other T lymphocyte subpopulations and B lymphocytes. The number and function of NK cells were additionally reduced during the therapy. In regard to activation of Tcells, r-HuEPO stimulated the production and expression of receptors for IL-2, especially on helper T cells, and transferrin receptors (CD71), but did not affect the HLA-DR expression (class H MHC antigen). The cytokine synthesis increased significantly as estimated by serum IFN, IL-6 and sIt-6R. r-HuEPO did not exert any additional effect on immunosuppression in the studied patients. Erythropoietin has no direct effect on NK cells. Observed stimulation of the surface receptors expression and induction of proinflammatory cytokines could facilitate the activation of T cells.
erythropoietin; hemodyalisis; immunocompentence
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