The effect of hemodialysis on the virgin CD45RA+, CD45RO- and memory CD45RO+, CD45RA- lymphocyte count in patients with chronic renal failure

The hallmark of immunological memory is a quick and effective response to a repeated antigen exposure. Virgin lymphocytes, with their surface receptors CD45RA+, CD45RO- are produced in primary lymphatic organs, then migrating to secondary lymphatic structures. Memory lymphocytes CD45RO+, CD45RA- produced in these organs migrate to non-lymphatic organs--a possible location of inflammatory process, thus enabling the immunological system to eliminate effectively the same antigen, when repeatedly present. The aim of the study was 1) to test the influence of hemodialysis on the number of virgin lymphocytes and/or memory lymphocytes; 2) whether such impact (if any) depends on the type of dialysis membrane used (cuprophan or polysulphon), 3) if the effect is different in patients with or without diabetes. Overall number of virgin T helper lymphocytes CD45RA+CD4+ was significantly lower in patients with end-stage renal disease, while the number of total CD45RO+, CD45RA- memory lymphocytes was significantly greater among patients with diabetic nephropathy, compared to normal control subjects. After 15 minutes of hemodialysis, number of virgin lymphocytes CD45RA+, CD45RO- (p < 0.001, p < 0.01) and their subclasses, as well as memory lymphocytes CD45RO+, CD45RA- were significantly decreased. After 15 minutes of hemodialysis with polysulphon membrane, the decrease in T virgin cytotoxic, B virgin CD45RA+CD4-, T memory cytotoxic as well as B memory CD45RO+CD4- lymphocytes was significantly lower, when compared with cuprophan membrane (p < 0.02). Among patients treated with cuprophan hemodialysis, the decrease of T helper memory CD45RO+CD4+ lymphocytes was significantly lower in patients with diabetic nephropathy, than in non-diabetic patients. CONCLUSIONS: In all patients with end-stage renal disease, the impact of hemodialysis on the number of memory lymphocytes CD45RO+, CD45RA-, as well as virgin lymphocytes CD45RA+, CD45RO- was shown, but the effect was less profound during hemodialysis with polysulphon membrane, compared to cuprophan. The presence of diabetic nephropathy effects the hemodialysis-induced changes in the number of T memory helper CD45RO+ CD45RO+CD4+ lymphocytes, with no impact on other subclasses of the examined cells.