Korean Journal of Nephrology 1990;9(1):9-18.

투석시작전 말기 신부전증 환자의 세포 면역 장애에 관한 연구 - 수혈이 세포 면역에 미치는 영향 -

하성규 , 최규헌 , 이호영 , 한대석 , 이봉기 , 김주덕

Abstract

The dominant immunologic defect in uremia resides in the cellular immune system. To investigate the im- muno 1ogic defects in uremia and the effect of transfusion on cell-mediated immunity, several parameters (I.e. leukocyte, lymphocyte, total T cell, T cell subest, stimu- lation index, and suppressor T cell function) of cell- mediated immunity were examined in 70 predialysis uremic patients and 29 healthy control subjects. The result were as follows: 1) The number of leukocytes in transfused predialysis uremic patients was significantly reduced compared to control subjects. The number of lymphocytes in predialysis uremic patients with or without transfusion was also significantly reduced compared to control subjects. 2) The proportions of total T-and suppressor- T cells were not significantly different between the predialysis uremic patients group and the control. However, the proportions of helper T cell were significantly lower in the uremic patients group than in the control (p<0.05). 3) Stimulation indices of PHA and Con A were not significantly different between the predialysis uremic patients group and the control but there was an increas- ing tendency in stimulation indices in transfused uremic patients compared to nontransfused uremic patients. 4) Suppressor cell removal index of Con A was signifi- cantly higher in nontransfused predialysis uremic patients than in the control and transfused predialysis uremic patients (p<0.05). In conclusion, cellular immune defects in uremia may be related to decreased proportion of helper T cell and enhanced suppressor cell activity. Transfusion probably affected to mitogen but there were no statistically sig- nificant differences between the transfusion positive and negative uremic group. Increased suppressor cell activ- ity was observed in nontransfused predialysis uremic patients. This increased activity was ameliorated in transfused predialysis uremic patients.