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The frequency of Th2 type cells increases with time on peritoneal dialysis in patients with diabetic nephropathy.
Zamauskaite A; Yaqoob MM; Madrigal JA; Cohen SB; The Anthony Nolan Bone
November 30, 1999
Eur Cytokine Netw. 1999 Jun;10(2):219-26. Unique Identifier : AIDSLINE

We have analysed the frequency of cytokine-producing T cells in different dialysis groups (haemodialysis; HD and peritoneal dialysis; PD) over time. Although we saw no difference in type 1 cytokine production (IL-2 and IFN-gamma) in either dialysis group, there was a clear increase in the percentage of T cells spontaneously producing the type 02 cytokines in the PD group (IL-4, r = 0.558, P < 0.05; IL-10, r = 0.527, p < 0.05). Our patient group was carefully selected to include patients with an ongoing autoimmune disease, insulin dependent diabetes mellitus (IDDM) (DN group) and chronic glomerulonephritis (GN), which are common reasons of end stage renal failure. As expected there was no increase in the spontaneous production of either IL-4 or IL-10 in either disease group with patients undergoing HD treatment. However, there was a clear correlation with the frequency of T cells producing IL-4 (r = 0.755, P < 0.05) and IL-10 (r = 0.725, P < 0.05) and time on dialysis in the PD patients with DN, but not those with GN. Much work has suggested that the pathogenesis of IDDM is associated with a Th1 dominated response. We show here that this response is skewed towards a Th2 response after long term treatment with PD. This work demonstrates that the immunological effects of different dialysis modalities on patients with different diseases vary. This may go some way to explain why certain patient groups have more complications with different dialysis modalities.

JOURNAL ARTICLE Autoimmune Diseases/COMPLICATIONS/IMMUNOLOGY/THERAPY Comparative Study *CD4 Lymphocyte Count Diabetes Mellitus, Insulin-Dependent/COMPLICATIONS/IMMUNOLOGY/ THERAPY Diabetic Nephropathies/*IMMUNOLOGY/THERAPY Glomerulonephritis/COMPLICATIONS/IMMUNOLOGY/THERAPY Hemodialysis Human Interleukin-10/SECRETION Interleukin-4/SECRETION Kidney Failure, Chronic/ETIOLOGY/*IMMUNOLOGY/THERAPY *Peritoneal Dialysis Support, Non-U.S. Gov't *Th2 Cells/SECRETION Time Factors