Effect of Telitacicept on Circulating Gd-IgA1 and IgA-Containing Immune Complexes in IgA Nephropathy.

Introduction: Telitacicept, a transmembrane activator and cyclophilin ligand interactor (TACI) fusion protein targeting B cell activating factor and a proliferation-inducing ligand (APRIL), has proven efficacy in treating Immunoglobulin A (IgA) nephropathy (IgAN). However, serum biomarkers that could predict the clinical response during the treatment remain unclear. Methods: Plasma samples from 24 participants in the phase 2 clinical trial were collected at baseline and after 4, 12, and 24 weeks; with 8 participants in the placebo group, 9 in the 160 mg group, and 7 in the 240 mg group. We measured the levels of galactose-deficient-IgA1 (Gd-IgA1), IgA-containing immune complexes, C3a, C5a, and sC5b-9. The association between the changes in these markers and proteinuria reduction was analyzed. Results: After 24 weeks of treatment, Gd-IgA1 decreased by 43.9% (95% confidence interval: 29.8%, 55.1%), IgG-IgA immune complex by 31.7% (14.4%, 45.5%), and poly-IgA immune complex by 41.3% (6.5%, 63.1%) in the 160 mg group; Gd-IgA1 decreased by 50.4% (38.6%, 59.9%), IgG-IgA immune complex decreased by 42.7% (29.5%, 53.4%), and poly-IgA immune complex decreased by 67.2% (48.5%,79.1%) in the 240 mg group. There were no significant changes in the circulatory C3a, C5a, or sC5b-9 levels during telitacicept treatment. Decreases in both plasma Gd-IgA1 and IgG-IgA or poly-IgA immune complexes were associated with proteinuria reduction. In turn, IgG-IgA or poly-IgA immune complexes showed a dose-dependent effect, consistent with proteinuria reduction during telitacicept treatment. Conclusion: Telitacicept lowered both circulating Gd-IgA1 and IgA-containing immune complexes, whereas IgA immune complex levels were more consistent with decreased proteinuria.

Meta-analysis of the correlation between pulmonary hypertension and echocardiographic parameters in patients with chronic kidney disease.

Objective: To investigate the correlation between pulmonary hypertension (PH) and echocardiographic parameters in patients with chronic kidney disease (CKD). Methods: PubMed, Embase, Web of Science, Cochrane, VIP, CNKI, and Wanfang databases were systematically searched for articles published from inception to 19 May 2023. Study quality was estimated using the Quality Assessment of Case-Control Studies tool. Forest plots were drawn using R language software. The "metacor" function in the "meta" package was utilized for meta-analysis of the r-values and their standard errors. Heterogeneity and sensitivity analyses were carried out, with the main outcomes as r-value, p-value, and I2 value. Results: Eleven studies were included, with 1,809 CKD patients. The correlations between 12 echocardiographic parameters and PH were analyzed. Except for FS and LVEF which were negatively correlated with CKD-PH, the other 10 parameters were positively correlated with CKD-PH. Among them, LA was highly correlated with CKD-PH (0.70 < r < 0.89); LVDD, RA, RV, LVMI, and LVDS were moderately correlated with CKD-PH (0.40 < r < 0.69); while PA, IVS, LVPW, SV, FS, and LVEF were lowly correlated with CKD-PH (0.20 < r < 0.39). The synthesized estimates were stable against heterogeneity. Conclusion: CKD-PH patients may have large cardiac chambers, thickened septal tissue on both sides of the chambers, reduced pulmonary artery flow rates, and decreased left ventricular function.

Pegmolesatide for the treatment of anemia in patients undergoing dialysis: a randomized clinical trial.

Background: Pegmolesatide, a synthetic peptide-based erythropoietin (EPO) receptor agonist, is being evaluated as an alternative to epoetin alfa for treating anemia of chronic kidney disease (CKD) in Chinese dialysis patients. There is a critical need for a long-acting, cost-effective erythropoiesis-stimulating agent that does not produce EPO antibodies. Methods: A randomized, open-label, active-comparator, non-inferiority phase three trial was conducted at 43 dialysis centers in China between May 17th, 2019, and March 28th, 2022. Eligible patients aged 18-70 years were randomly assigned (2:1) to receive pegmolesatide once every four weeks or epoetin alfa one to three times per week, with doses adjusted to maintain a hemoglobin level between 10.0 and 12.0 g/dL. The primary efficacy endpoint was the mean change in hemoglobin level from baseline to the efficacy evaluation period in the per-protocol set (PPS) population. Non-inferiority of pegmolesatide to epoetin alfa was established if the lower limit of the two-sided 95% confidence interval for the between-group difference was ≥ -1.0 g/dL. Safety assessment included adverse events and potential anaphylaxis reactions. This trial is registered at ClinicalTrials.gov, NCT03902691. Findings: Three hundreds and seventy-two patients were randomly assigned to the pegmolesatide group (248 patients) or the epoetin alfa group (124 patients). A total of 347 patients (233 in the pegmolesatide group and 114 in the epoetin alfa group) were included in the PPS population. In the PPS, the mean change (standard deviation, SD) in hemoglobin level from baseline to the efficacy evaluation period was 0.07 (0.92) g/dL in the pegmolesatide group and -0.22 (0.97) g/dL in the epoetin alfa group. The between-group difference was 0.29 g/dL (95% confidence interval: 0.11-0.47), verifying non-inferiority of pegmolesatide to epoetin alfa. Adverse events occurred in 231 (94%) participants in the pegmolesatide group and in 110 (89%) in the epoetin alfa group. Hypertension was the most common treatment-related adverse event. No fatal cases of anaphylaxis or hypotension were reported. Interpretation: Monthly subcutaneously injection of pegmolesatide was as effective and safe as conventional epoetin alfa administrated one to three times a week in treating anemia in Chinese dialysis patients. Funding: The study was supported by Hansoh Medical Development Group.

Randomized Phase 2 Trial of Telitacicept in Patients With IgA Nephropathy With Persistent Proteinuria.

Introduction: To date, no specific therapies have been approved for immunoglobulin A nephropathy (IgAN) treatment. Telitacicept is a fusion protein composed of transmembrane activator and calcium-modulating cyclophilin ligand interactor and fragment crystallizable portion of immunoglobulin G (IgG), which neutralizes the B lymphocyte stimulator and a proliferation-inducing ligand. Methods: This phase 2 randomized placebo-controlled trial aimed to evaluate the efficacy and safety of telitacicept in patients with IgAN. Participants with an estimated glomerular filtration rate (eGFR) >35 ml/min per 1.73 m2 and proteinuria ≥0.75 g/d despite optimal supportive therapy, were randomized 1:1:1 to receive subcutaneous telitacicept 160 mg, telitacicept 240 mg, or placebo weekly for 24 weeks. The primary end point was the change in 24-hour proteinuria at week 24 from baseline. Results: Forty-four participants were randomized into placebo (n = 14), telitacicept 160 mg (n = 16), and telitacicept 240 mg (n = 14) groups. Continuous reductions in serum IgA, IgG, and IgM levels were observed in the telitacicept group. Telitacicept 240 mg therapy reduced mean proteinuria by 49% from baseline (change in proteinuria vs. placebo, 0.88; 95% confidence interval, -1.57 to -0.20; P = 0.013), whereas telitacicept 160 mg reduced it by 25% (-0.29; 95% confidence interval, -0.95 to 0.37; P = 0.389). The eGFR remained stable over time. Adverse events (AEs) were similar in all groups. Treatment-emergent AEs were mild or moderate, and no severe AEs were reported. Conclusion: Telitacicept treatment led to a clinically meaningful reduction in proteinuria in patients with IgAN in the present phase 2 clinical trial. This effect is indicative of a reduced risk for future kidney disease progression.

Development and validation of a model to predict acute kidney injury following wasp stings: A multicentre study.

OBJECTIVE: To establish and validate a model to predict acute kidney injury (AKI) following wasp stings. METHODS: In this multicentre prospective study, 508 patients with wasp stings from July 2015 to December 2019 were randomly divided into a training set (n = 381) and a validation set (n = 127) for internal and external validation. Risk factors were identified, and a model was established to predict the probability of AKI following multiple wasp stings using an individual nomogram and a predictive formula. The performances of the model were assessed by using the area under the curve (AUC), accuracy (ACC) of the receiver operating characteristic curve and decision curve analysis. RESULTS: The number of stings, aspartate aminotransferase >147 U/L, lactate dehydrogenase >477 U/L, time from stings to admission >12 h and activated partial thromboplastin time >49 s were demonstrated to be independent risk factors for AKI following wasp stings (all P value < 0.05) and were incorporated into the model. The performances of the model were validated (AUC = 0.950 [95% CI: 0.923 to 0.969], ACC = 0.916 and AUC = 0.953 [95% CI: 0.900 to 0.982], ACC = 0.906 in the training set and validation set, respectively). The predictive formula and the nomogram of the model could be utilized to predict AKI following wasp stings, which have sufficient accuracies, good predictive capabilities and good net benefits. CONCLUSION: The predictive formula and the individual nomogram of the model might serve as promising predictive tools to assess the probability of AKI following wasp stings.

A comparative analysis of high-flux and low-flux dialysis in cervical cancer patients with obstructive renal failure showing no significantly improved renal function after catheterisation.

OBJECTIVE: This study aims to compare the clinical application value of high-flux dialysis with low-flux dialysis in patients without significantly improved renal function after cervical cancer and obstructive renal failure catheterisation. METHODS: This prospective randomised study was conducted from January 2018 to December 2019. Eighty cervical cancer patients with obstructive renal failure who showed no significant renal function improvement after catheterisation were randomised into two groups (n = 40 in each group) in the Second People's Hospital of Yibin City. High-flux and low-flux dialysis were employed in the experimental group and the control group, respectively. Treatments in both groups were provided every other day, with the whole course lasting one week. Data were recorded before and after dialysis included inflammatory factors such as IL-6, CRP and TNF-a, large and moderate molecular toxins (e.g., ß2 micro-globulin, parathyrin (PTH) and cysteine protease inhibitor). Renal function changes during the dialysis were also recorded. Afterwards, the two groups were compared regarding the overall efficacy. RESULTS: Both the experimental group and the control group experienced a significant decrease in IL-6, CRP, TNF-a, ß2 micro-globulin, PTH and cysteine protease inhibitor, with the decrease in the experimental group being more evident (p < 0.05). After dialysis was completed, the experimental group restored renal function indicators such as Cre, CysC and serum K+ levels more quickly than the control group (p < 0.05). The effective rate was 100% for the experimental group and 87.5% for the control group. The intragroup difference in the efficacy.was significant. CONCLUSIONS: High-flux dialysis appears to be more beneficial for cervical cancer patients with obstructive renal failure, showing no significant improvement in renal function after catheterisation. It restored renal function more quickly, had more radical draining of inflammatory factors and large and moderate molecular toxins, and had a higher overall effective rate.

Sulforaphane alleviates hepatic ischemia-reperfusion injury through promoting the activation of Nrf-2/HO-1 signaling.

BACKGROUND: Sulforaphane (SFN)displays both anti-oxidative stress and anti-inflammatory activity. Given that inflammation and oxidative stress play important roles in hepatic ischemia-reperfusion injury (HI/RI), we examined the protective effect and potential mechanism of SFN on HI/RI. METHODS: The maneuver of Pringle's was used to establish the mode of HI/RI and 60 SD rats were randomly divided into Sham, HI/RI, SFN and ML385 Groups. The expression of aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), Nuclear factor-E2-related factor 2(Nrf-2), heme oxygenase 1(HO-1), nitric oxide (NO), Cyclooxygenase2 (COX-2), NADPH quinone oxidoreductase 1 (NQO1), malondialdehyde (MDA), tumor necrosis factor-a (TNF-a), interleukin-6 (IL-6) and monocyte chemotactic protein 1(MCP-1) were measured. Moreover, hepatic pathological morphology and the activity of glutathione (GSH), Catalase (CAT), superoxide dismutase (SOD) of the liver were also examined. RESULTS: SFN treatment can significantly decrease the hepatic pathological injury and down-regulate the expression of ALT, AST, ALP, COX-2, TNF-a, IL-6, MCP-1, NO and MDA in HI/RI with increasing the expression of Nrf2, NQO1 and HO-1, and up-regulating the activity of GSH, CAT and SOD. Moreover, Nrf-2 inhibitor, ML385 can obliviously reverse the protective effect of SFN on HI/RI. CONCLUSION: Sulforaphane can inhibit the inflammatory response and oxidative stress induced by HI/RI through promoting the activation of the Nrf-2 / HO-1 signal pathway.

Preclinical activity of cobimetinib alone or in combination with chemotherapy and targeted therapies in renal cell carcinoma.

Background: The poor outcome of advanced renal cell carcinoma (RCC) necessitates new treatments. Cobimetinib is a MEK inhibitor and approved for the treatment of melanoma. This work investigated the efficacy of cobimetinib alone and in combination with anti-RCC drugs. Methods: Proliferation and apoptosis assays were performed, and combination index was analyzed on RCC cell lines (CaKi-2, 786-O, A-704, ACHN and A489) and xenograft models. Immunoblotting analysis was conducted to investigate the MAPK pathway. Results: Cobimetinib was active against RCC cells, with IC50 at 0.006-0.8µM, and acted synergistically with standard-of-care therapy. Cobimetinib at nontoxic doses prevented tumor formation, inhibited tumor growth and enhanced efficacy of 5-fluorouracil, sorafenib and sunitinib via suppressing Raf/MEK/ERK, leading to MAPK pathway inhibition. Conclusion: Our findings demonstrate the potent anti-RCC activity of cobimetinib and its synergism with RCC standard-of-care drugs, and confirm the underlying mechanism of the action of cobimetinib.

Analysis of the prevalence and influencing factors of depression and anxiety among maintenance dialysis patients during the COVID-19 pandemic.

OBJECTIVE: Currently, the COVID-19 outbreak and its spread around the globe is significantly affecting mental health and health in general, worldwide. During the COVID-19 pandemic, the general medical complications have received the most attention, whereas only a few studies address the potential direct impact of SARS-CoV-2 on mental health. METHODS: A total of 321 maintenance hemodialysis (MHD) patients were selected using random sampling from the hemodialysis center of the second people's Hospital of Yibin. They completed Zung's self-rating anxiety scale (SAS) for anxiety, Zung's self-rating depression scale (SDS) for depression, and the activity of daily living scale (ADL) for the ability of living. Demographic data and laboratory tests were used to analyze the risk factors. RESULTS: The proportions of the prevalence of anxiety and depression symptoms were between 34.89% and 30.02%, respectively, among the MHD patients. The SAS and SDS scores of the 321 patients were 45.42(± 10.99) and 45.23(± 11.59), respectively. The results show that monthly income, medical insurance, vascular access, the duration of dialysis, complication, hemoglobin (HGB), immunoreactive parathyroid hormone (iPTH) and blood phosphorus (P) are factors that influence anxiety among patients (p < 0.05 for all). Vascular access, monthly income, medical insurance, complication, CRP, Alb, are factors that influence depression among patients (p < 0.05 for all). CONCLUSION: Our results suggest that during the pandemic period, the prevalence of anxiety and depression symptoms among MHD patients increased. Some demographic and clinical variables were associated with it. We should, therefore, pay more attention to the patients' psychology, start targeted intervention to alleviate the patients' anxiety and further improve their quality of life.

Osthole Blocks HMGB1 Release From the Nucleus and Confers Protective Effects Against Renal Ischemia-Reperfusion Injury.

Renal ischemia-reperfusion (IR) is one of the main causes of renal injury. In severe cases with serious consequences, IR-related renal damage progresses rapidly and can even lead to acute renal failure. Its clinical treatment is currently difficult. According to various studies at home and abroad, HMGB1 is released from the nucleus into the cytoplasm or extracellular space by damaged parenchymal cells during ischemia and hypoxia, and this plays an important role in the initiation of reperfusion injury as an early inflammatory factor and is closely related to the occurrence and development of renal diseases. In recent years, the protective effect of osthole on IR of tissues and organs has been a key topic among clinical researchers. Osthole can inhibit the inflammatory response, reduce cell apoptosis the progression, and improve the prognosis of IR, thus protecting the kidney. During the development of renal IR, finding a mechanism through which the osthole blocks the release of HMGB1 from the nucleus would be helpful in detecting targets for clinical treatment.

IgA nephropathy suspected to be combined with Fabry disease or Alport syndrome: a case report.

Immunoglobulin A (IgA) nephropathy is the most common glomerular disease, and it often manifests as persistent microscopic hematuria or gross hematuria. Fabry disease and Alport syndrome are hereditary diseases caused by mutation of genes, and these diseases are rare in China. At present, patients can be diagnosed with IgA nephropathy by clinical manifestations and laboratory examinations, but there is still controversy about the simultaneous diagnosis of Alport syndrome and Fabry disease in patients with IgA nephropathy. The present case was a 17-year-old girl with hematuria and proteinuria who underwent a renal biopsy. Light microscopy and immunofluorescence showed that IgA was deposited in the mesangium. Under electron microscopy, zebra bodies with a lamellated structure were detected. A gene test showed a COL4A3 gene mutation. The patient was administered prednisone 40 mg once a day and dispersible tablets of mycophenolate mofetil 0.75 g two times a day. The patient's condition showed a trend of remission. The findings in our case emphasize the importance of renal biopsy and gene detection in hereditary kidney disease, especially for Fabry disease and its rare coexistence with Alport syndrome.

Molecular characteristics and pathogenicity analysis of QX-like avian infectious bronchitis virus isolated in China in 2017 and 2018.

Proportions of QX-like genotype infectious bronchitis virus (IBV) isolates have increased over time. Here, to better understand the epidemiology and pathogenicity of IBV in China and control the spread of infectious bronchitis (IB), we conducted sequence analyses and examined the pathogenicity of 5 field isolates from diseased flocks in 2017 and 2018. Sequence analyses revealed that all the 5 strains, as well as many recent field isolates from other researchers, belonged to the QX-like IBV genotype, which were distantly related to commercial vaccine strains. Viral pathogenicity experiments showed that the isolates caused high morbidity and severe ciliostasis in chickens, although they caused milder lethality. This provides further evidence that QX-like IBV emergence remains a major problem in the poultry industry, and information on IBV epidemiology and pathogenicity may help to control IB.

Pathogenicity of a GI-22 genotype infectious bronchitis virus isolated in China and protection against it afforded by GI-19 vaccine.

Avian infectious bronchitis (IB) is a globally circulating bird disease caused by infectious bronchitis virus (IBV). In China, the most prevalent IBV genotype is GI-19/QX-like because the protective efficiency of the classical IBV vaccine is low, and new GI-19 vaccines are under development. In 2018, a GI-22 genotype strain CK/CH/LGD/2018 (abbreviated 'LGD') was isolated in northern China, which caused 10%-30% morality in H120-vaccinated chickens. A phylogenetic analysis showed that this new isolate displays novel features compared with other earlier-isolated reference strains. To monitor the epidemic trend of IBV in China, the pathogenicity of LGD was first evaluated in 1-day-old specific-pathogen-free chickens. LGD induced classical IBV damage in the trachea and kidney, whereas it also infected and damaged the bursa of Fabricius, an important immune organ of chickens. The efficacy of our earlier-developed GI-19 vaccine, strain SZ200, against LGD was also evaluated in this study. The GI-19 genotype vaccine provided sufficient protection against the new GI-22 genotype strain, and may be a promising candidate vaccine with which to control both wild GI-19 and GI-22 strains in the future.

Attenuation, safety, and efficacy of a QX-like infectious bronchitis virus serotype vaccine.

Avian infectious bronchitis (IB) is a highly contagious disease caused by avian infectious bronchitis virus (IBV), which is a considerable economic threat to the poultry industry. QX-like IBV strains have increasingly emerged in China in recent years. Hence, development of a specific vaccine to guard against their potential threat is important. In this study, we sought to develop an attenuated vaccine strain. First, attenuated QX-like IBV strain SZ130 was created by continuous passage in chicken embryos for 130 generations, and then its safety was tested. We also evaluated the protective efficacy of different doses of SZ130 against challenge with QX-like IBV field strain SD in chickens. SZ130-infected birds did not experience IB-like signs and organ lesions. Additionally, an excellent protective effect of SZ130 vaccination was observed when vaccinated birds were challenged with SD, with no clinical signs or gross lesions, decreased target tissue replication rates, and lower ciliostasis scores in all immunized groups. These findings indicate that attenuated IBV strain SZ130 is highly safe in chicks and may serve as an effective vaccine against the threat posed by QX-like IBV strains.

Isolation and Characterization of China Isolates of Duddingtonia flagrans, a Candidate of the Nematophagous Fungi for Biocontrol of Animal Parasitic Nematodes.

The nematophagous fungus Duddingtonia flagrans has been investigated as a biological agent for the control of gastrointestinal nematodes infecting domestic animals in other countries. However, D. flagrans has not been detected in China. In this study 1,135 samples were examined from 2012 to 2014; 4 D. flagrans isolates (SDH 035, SDH 091, SFH 089, SFG 170) were obtained from the feces of domestic animals and dung compost. The 4 isolates were then characterized morphologically. The SDH 035 strain was characterized by sequencing the ITS1-5.8S rDNA-ITS2 region. A BLAST search showed that the SDH 035 strain (GenBank KP257593) was 100% identical to Arthrobotrys flagrans (AF106520) and was identified as D. flagrans. The morphological plasticity of the isolated strain and the interaction of this strain with the nematode targets were observed by subjecting the infected trichostrongylide L3 to scanning electron microscopy. At 6 and 8 hr after trichostrongylide L(3) was added, hyphal ramifications were observed and L(3) were captured, respectively. Scanning electron micrographs were obtained at 0, 6, 12, 18, 24, 30, 36, 42, and 48 hr, where 0 is the time when trichostrongylide L(3) were first captured by the fungus. The details of the capture process by the fungus are also described. Chlamydospores were observed in the body of L(3) in the late stage of digestion. A sticky substance and bacteria could be observed in contact areas between predation structures and nematode cuticle.

Isolation, identification, and characterization of the nematophagous fungus Monacrosporium salinum from China.

Nematophagous fungi are considered to have the best potential as biological agents for the control of gastrointestinal nematodes in domestic animals. However, relatively few studies have been conducted with the genus Monacrosporium, especially with strains native to China. In the present study, we isolated and identified nematophagous fungi from fresh sheep feces. A pure fungal strain was molecularly characterized, and its nematophagous activity was evaluated. The morphological plasticity of the isolated strain, as well as its interaction with the nematode targets, was observed by scanning electron microscopy of the infected Trichostrongylus colubriformis L3 and the free-living nematode Caenorhabditis elegans. Three isolated fungal strains from the 30 fresh fecal samples of sheep from Inner Mongolia, China exhibited predatory activity; however, only a single strain was successfully purified (SF 0459). The SF 0459 strain was characterized by morphological analysis of its conidia and sequencing of its ITS1-5.8S rDNA-ITS2 region. This strain was identified to be Monacrosporium salinum (GenBank ID: KP036623). Nematophagous fungus helper bacteria were found at the interaction points between fungi and nematodes. The percentage of live T. colubriformis L3 was reduced by 83.79-88.69% based on the in vitro assay.

[Expression of Bcl-2 and Fas and apoptosis of T lymphocyte in the peripheral blood of patients with end-stage renal diseases].

OBJECTIVE: To investigate the expression of Bcl-2 and Fas and the apoptosis of T lymphocyte in the peripheral blood of patients with end-stage renal diseases; and to test the impact of various dialysis membranes on the apoptosis of T lymphocyte. METHODS: T lymphocyte was cultured with the stimulation of Phytohemagglutinin (PHA) for 24 h. The apoptosis of T lymphocyte was measured by flow cytometry. The expression of Bcl-2 and Fas was measured with immunohistochemical approach. A total of 10 non-dialyszed (ND) patients, 45 maintenance hemodialysis patients with cellulose acetate (CA) membrane, low-flux (PS-LF) and high-fluxpolusulfone (PS-HF) membrane, and 8 healthy volunteers (HC) participated in the study. RESULTS: The patients with end-stage renal diseases had greater apoptosis of T lymphocyte than healthy volunteers (P < 0.01). The patients undergoing hemodialysis with CA membrane had greater apoptosis of T lymphocyte than those with PS-LF and PS-HF membranes (P < 0.05). The expression of Bcl-2 in T lymphocyte of patients with end-stage renal diseases was lower than that of healthy valunteers (P < 0. 01). The apoptosis of T lymphocyte was negatively correlated with the expression of Bcl-2 (r = -0. 83, P < 0.01). The expression of Fas in T lymphocyte of patients with end-stage renal diseases was greater than that of healthy valunteers (P < 0.01). The apoptosis of T lymphocyte was positively correlated with the expression of Fas (r = 0.81, P < 0.01). CONCLUSION: Patients with end-stage renal diseases may experience accelerated apoptosis of T lymphocyte, which is associated with the high expression of Fas and low expression of Bcl-2 in T lymphocyte. The apoptosis of T lymphocyte is also influenced by the permeability of the dialysis membranes.

[The characterization of Th1/Th2 profile in end-stage renal disease patients and the correlation with the apoptosis of T lymphocyte].

AIM: To investigate the characterization of Th1/Th2 profile in patients with end-stage renal disease (ESRD) and the correlation with the apoptosis of the peripheral blood T cells; and to study the influence of different dialysis membranes on the apoptosis of T lymphocyte. METHODS: T cells from 10 non-dialyzed (ND) patients, 45 maintenance hemodialysis patients with cellulose acetate (CA) membrane, low-flux (PS-LF) and high-flux polusulfone (PS-HF) membrane, and 8 healthy volunteers (HC) were separated and stimulated with PHA for 24 hours in vitro. Then the apoptosis of T cells and supernatants levels of IFN-gamma and IL-4 were detected by Flow cytometry (FCM) and ELISA. RESULTS: In ESRD patients, the expression of Annexin V in T lymphocyte was higher than that of group HC (P<0.05), group CA was higher than group PS-HF and PS-LF (P<0.05). The level of IFN-gamma of ESRD patients was decreased significant compared with that in group HC (P<0.05), and there was negative correlation. between the Annexin V and IFN-gamma. IL-4 was increased in ESRD patients (P<0.05) and it was positive correlated with Annexin V. CONCLUSION: ESRD patients showed suppressed secretion of IFN-gamma, increased secretion of IL-4 and apoptosis of T lymphocytes.