A comprehensive characterization of aggravated aging-related changes in T lymphocytes and monocytes in end-stage renal disease: The iESRD study

Yen Ling Chiu, Kai Hsiang Shu, Feng Jung Yang, Tzu Ying Chou, Ping Min Chen, Fang Yun Lay, Szu Yu Pan, Cheng Jui Lin, Nicolle H.R. Litjens, Michiel G.H. Betjes, Selma Bermudez, Kung Chi Kao, Jean San Chia, George Wang, Yu Sen Peng, Yi Fang Chuang

Research output: Contribution to journalArticle

Abstract

Background: Patients with end-stage renal disease (ESRD) exhibit a premature aging phenotype of the immune system. Nevertheless, the etiology and impact of these changes in ESRD patients remain unknown. Results: Compared to healthy individuals, ESRD patients exhibit accelerated immunosenescence in both T cell and monocyte compartments, characterized by a dramatic reduction in naïve CD4+ and CD8+ T cell numbers but increase in CD8+ TEMRA cell and proinflammatory monocyte numbers. Notably, within ESRD patients, aging-related immune changes positively correlated not only with increasing age but also with longer dialysis vintage. In multivariable-adjusted logistic regression models, the combination of high terminally differentiated CD8+ T cell level and high intermediate monocyte level, as a composite predictive immunophenotype, was independently associated with prevalent coronary artery disease as well as cardiovascular disease, after adjustment for age, sex, systemic inflammation and presence of diabetes. Levels of terminally differentiated CD8+ T cells also positively correlated with the level of uremic toxin p-cresyl sulfate. Conclusions: Aging-associated adaptive and innate immune changes are aggravated in ESRD and are associated with cardiovascular diseases. For the first time, our study demonstrates the potential link between immunosenescence in ESRD and duration of exposure to the uremic milieu.

Original languageEnglish (US)
Article number27
JournalImmunity and Ageing
Volume15
Issue number1
DOIs
StatePublished - Nov 8 2018

Keywords

  • Aging
  • CVD
  • ESRD
  • Immunosenescence
  • Inflammation

ASJC Scopus subject areas

  • Immunology
  • Aging

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    Chiu, Y. L., Shu, K. H., Yang, F. J., Chou, T. Y., Chen, P. M., Lay, F. Y., Pan, S. Y., Lin, C. J., Litjens, N. H. R., Betjes, M. G. H., Bermudez, S., Kao, K. C., Chia, J. S., Wang, G., Peng, Y. S., & Chuang, Y. F. (2018). A comprehensive characterization of aggravated aging-related changes in T lymphocytes and monocytes in end-stage renal disease: The iESRD study. Immunity and Ageing, 15(1), [27]. https://doi.org/10.1186/s12979-018-0131-x