Objective To investigate the relationship between the expression of CC chemokine receptor 5 (CCR5) mRNA in peripheral γδ T cells and the prognosis of maintenance hemodialysis (MHD) patients. Methods A total of 191 MHD patients (MHD group) and a total of 109 healthy subjects (control group) in Jiangning Hospital Affiliated to Nanjing Medical University in the period from January 2018 to December 2020 were recruited in this study. Laboratory indexes and CCR5 mRNA expression in peripheral γδ T cells were examined. After 3 years of follow-up, the MHD patients were divided into survival group (n=160) and death group (n=31). The correlation of CCR5 mRNA in peripheral γδ T cells with age, dialysis age, hemoglobin (Hb), albumin (ALB), hypersensitive C-reactive protein (hs-CRP) and tumor necrosis factor (TNF)-α were analyzed. The factors affecting the 3-year survival of MHD patients, and the predictive value of CCR5 mRNA in peripheral γδ T cells for 3-year survival in MHD patients were evaluated. Results Compared with control group, Hb, ALB and blood calcium decreased significantly (t=10.172, 4.702 and 7.702 respectively; P<0.001), while blood phosphorus, serum creatinine, blood urea nitrogen, intact parathyroid hormone, hs-CRP, TNF-α and CCR5 mRNA in peripheral γδ T cells increased significantly (t=20.196, 77.626, 52.291, 80.126, 42.637, 46.766 and 57.854 respectively; P<0.001) in MHD group. In death group, age, dialysis age, hs-CRP, TNF-α, CCR5 mRNA in peripheral γδ T cells increased significantly (t=4.525, 13.841, 14.991, 20.662 and 54.229 respectively; P<0.001), while Hb and ALB decreased significantly (t=8.783 and 15.190; P<0.001), as compared those in survival group. In MHD patients, CCR5 mRNA in peripheral γδ T cells was positively correlated with age, dialysis age, hs-CRP and TNF-α (r=0.448, 0.463, 0.567 and 0.405 respectively; P<0.001), and negatively correlated with Hb and ALB (r=-0.502 and -0.491; P<0.001). Age (HR=2.250, 95% CI: 1.228～4.123, P=0.009), dialysis age (HR=3.196, 95% CI: 1.454～7.028, P=0.004), hs-CRP (HR=3.717, 95% CI: 1.876～7.367, P<0.001), TNF-α (HR=2.497, 95% CI: 1.193～5.227, P=0.015) and CCR5 mRNA in peripheral γδ T cells (HR=2.358, 95% CI: 1.439～3.865, P=0.001) were the independent risk factors, while Hb (HR=0.401, 95% CI: 0.204～0.787, P=0.008) and ALB (HR=0.456, 95% CI: 0.241～0.862, P=0.016) were the independent protective factors for 3-year survival in MHD patients. The area under curve of CCR5 mRNA in peripheral γδ T cells for predicting 3-year survival in MHD patients was 0.927, with the sensitivity of 85.71% and the specificity of 93.96%. Conclusions The expression of CCR5 mRNA in peripheral blood γδT cells is higher in MHD patients, and has a predictive value for 3-year survival in MHD patients.
LI Xiao-Li
. The relationship between the expression CCR5 mRNA in peripheral blood gamma delta T cells and the prognosis of maintenance hemodialysis patients[J]. Chinese Journal of Blood Purification, 2024
, 23(11)
: 833
-838
.
DOI: 10.3969/j.issn.1671-4091.2024.11.007
参考文献
[1] ?zcan B, Güner M, Ceylan S, et al. Calf circumference predicts sarcopenia in maintenance hemodialysis[J]. Nutr Clin Pract, 2024, 39(1):193-201.
[2] Yang L, Xiao M. A survey on the level of health beliefs in preventing malnutrition in maintenance hemodialysis patients[J]. Minerva Surg, 2023, 78(6):748-750.
[3] Wei S, Jiao J, Yu Y, et al. Long-term arteriovenous fistula prognosis for maintenance hemodialysis patients who accepted PIRRT by using arteriovenous fistula[J]. Int J Artif Organs, 2023, 46(4):195-201.
[4] Mensurado S, Blanco-Domínguez R, Silva-Santos B. The emerging roles of γδ T cells in cancer immunotherapy[J]. Nat Rev Clin Oncol, 2023, 20(3):178-191.
[5] 温建强, 李丽娟, 曾彩虹. γδT细胞在肾病中的研究进展[J]. 医学研究生学报, 2022, 35(11):1226-1232.
[6] Zeng Z, Lan T, Wei Y, et al. CCL5/CCR5 axis in human diseases and related treatments[J]. Genes Dis, 2022, 9(1):12-27.
[7] Fuhro MI, Andrade FP, Dorneles GP, et al. The impact of intradialytic exercise on immune cells expressing CCR5+ in patients with chronic kidney disease: A cross-over trial[J]. Int J Artif Organs, 2022, 45(2):221-226.
[8] 上海市肾内科临床质量控制中心专家组. 慢性肾脏病早期筛查、诊断及防治指南（2022年版）[J].中华肾脏病杂志, 2022, 38(5):453-464.
[9] Sahutoglu T, Erinc O, Avsar FN. The impact of medium cut-off dialyzers on malnutrition-inflammation scores in maintenance hemodialysis patients[J]. Blood Purif, 2024, 53(3):219-228.
[10] Yamada S, Arase H, Taniguchi M, et al. A simple score for malnutrition-inflammation complex syndrome (MICS) is associated with the risk of mortality in Japanese patients undergoing maintenance hemodialysis[J]. Ther Apher Dial, 2024, 28(2):206-217.
[11] He X, Liu Y. Effects of arteriovenous fistulas and central venous catheters on the cardiac function and prognosis of patients on maintenance hemodialysis[J]. Pak J Med Sci, 2023, 39(3):780-784.
[12] Yu L, Zu Y, Lu J, et al. Higher serum magnesium is a survival advantage in maintenance hemodialysis patients[J]. Blood Purif, 2023, 52(4):382-391.
[13] de Vries NL, van de Haar J, Veninga V, et al. γδ T cells are effectors of immunotherapy in cancers with HLA class I defects[J]. Nature, 2023, 613(7945):743-750.
[14] Gao Z, Bai Y, Lin A, et al. Gamma delta T-cell-based immune checkpoint therapy: attractive candidate for antitumor treatment[J]. Mol Cancer, 2023, 22(1):31-44.
[15] Festa BP, Siddiqi FH, Jimenez-Sanchez M, et al. Microglial-to-neuronal CCR5 signaling regulates autophagy in neurodegeneration[J]. Neuron, 2023, 111(13):2021-2037.
[16] Wu QL, Cui LY, Ma WY, et al. A novel small-molecular CCR5 antagonist promotes neural repair after stroke[J]. Acta Pharmacol Sin, 2023, 44(10):1935-1947.
[17] 石金沙, 石浩龙, 左涵珺, 等. 天麻素通过CCR5/JAK1/STAT1信号通路抑制缺血缺氧新生小鼠小胶质细胞介导的炎症反应[J]. 中国病理生理杂志, 2024, 40(2):309-316.
[18] Wu S, Yang S, Li R, et al. HSV-1 infection-induced herpetic neuralgia involves a CCL5/CCR5-mediated inflammation mechanism[J]. J Med Virol, 2023, 95(4):e28718.
[19] Szczepańska M, S?dek ?, Bulsa J, et al. Chemokine receptors on peripheral blood T lymphocytes in children on peritoneal dialysis[J]. Perit Dial Int, 2021, 41(2):194-201.
[20] Li W, Wang J, Wang Y, et al. Additional hemoperfusion for patients receiving maintenance hemodialysis: a retrospective analysis[J]. Am J Transl Res, 2023, 15(6):4045-4054.
[21] Li J, Li H, Deng W, et al. The effect of combination use of hemodialysis and hemoperfusion on microinflammation in elderly patients with maintenance hemodialysis[J]. Blood Purif, 2022, 51(9):739-746.
