Korean Journal of Nephrology 1991;10(2):185-192.

요독증 환자의 면역반응 ( 3 . 요독혈청이 세포의 체외증식 반응에 미치는 영향 )

송경일 , 박민선 , 한동철 , 이상구 , 박춘식 , 황승덕 , 이희발

Abstract

Impaired immune responses in uremia have been associated with decrease in the number of circulating lymphocytes, functional defect of lymphocytes, monocytes or both and/or inhibitors of immune respon- se in the uremic sera. We have recently shown that T cells from uremic nonresponders to hepatitis B vaccine have decreased in vitro proliferative responses to PHA and anti-CD3 monaclonal antibody despite normal IL2 production but have normal responses to mitogenic combinationn of anti-CD2 monoclonal antibidies (9-1 and 9. 6) suggesting that functional defects of both lymphocyte and monocyte exist in this populaton. In order to assess the role of uremic serum in the impaird immune responses in uremia and to investigate the differential effects of sera from responders and nonresponders to hepatitis B vaccine and also from HBV carriers on T cell responses we measured in vitro proliferative responses to PHA of PBMC, in the pres- ence of normal or uremic sera, from normal control subjects and hemodialysis patients. Pooled uremic sera suppressed proliferative responses of PBMC from both normal control subjects and dialysis patients. Proliferative responses of normal PBMC were equally suppressed by both normal nonresponder and normal carrier sera and also by all three uremic sera. Uremic carrier serum was more suppressive than any other serum. Proliferative responses of uremic PBMC in the pres- ence of pooled normal sera were significantly higher than that in the presence of pooled uremic sera but were still significantly lower than the responses of normal PBMC in either normal or uremic pooled sera. Prolifer- ative responses of uremic PBMC were significantly lower than that of normal PBMC ia the presence of either normal or uremic sera separately or pooled. The results of this study suggest that uremic sera play an important role in the impaired immune responses in uremia but that functional defects of lymphocyte and/or monocyte may play an equally important role.