ESPN 54th Annual Meeting

ESPN 2022


 
IMPAIRED T CELL RECEPTOR REPERTOIRE IN CHILDREN WITH CHRONIC KIDNEY DISEASE
EMINE ULGEN 1 AYÇA KIYKIM 2 SEHA SAYGILI 3 NIHAN BURTECENE 2 HALUK ÇOKUĞRAŞ 2 SALIM ÇALIŞKAN 3 NUR CANPOLAT 3

1- DEPARTMENT OF PEDIATRICS, CERRAHPAŞA FACULTY OF MEDICINE, ISTANBUL UNIVERSITY-CERRAHPAŞA, ISTANBUL, TURKEY
2- DEPARTMENT OF PEDIATRIC ALLERGY AND IMMUNOLOGY, CERRAHPAŞA FACULTY OF MEDICINE, ISTANBUL UNIVERSITY-CERRAHPAŞA, ISTANBUL, TURKEY
3- DEPARTMENT OF PEDIATRIC NEPHROLOGY, CERRAHPAŞA FACULTY OF MEDICINE, ISTANBUL UNIVERSITY-CERRAHPAŞA, ISTANBUL, TURKEY
 
Introduction:

 Chronic kidney disease (CKD) is associated with immune dysregulation, including impaired cellular immune function. T lymphocytes are actively involved in the cellular immune response by recognizing and presenting antigens and cause the target cell to be lysed with a cytotoxic effect. The T cell receptor (TCR) on the surface of T lymphocytes provides clonal expansion and response against the antigen. In this study, we evaluated the TCR Vβ repertoire to investigate possible disturbances in the cellular response due to uremia.

Material and methods:

 This single center cross-sectional study included 35 patients with CKD younger than 20 years (21 CKD stage 3-4 and 14 CKD stage 5-dialysis) and 15 age- and sex-matched healthy controls. The clinical data of the patients were obtained from their medical records. Lymphocyte subgroups and TCR Vβ repertoire were assessed with a flow cytometry device simultaneously with complete blood count.

Results:

 The median age of the patients 12.3 (8.6-19) years and the median lymphocyte count was 2300 (1800-2900)/µl. There were no significant differences between patients and controls in terms of age, lymphocyte count, or lymphocyte subgroups (CD3, CD4, CD8 T cells, CD4/CD8 ratio and CD16/56 NK). However, the expressions of TCR Vβ 9, TCR Vβ 11, and TCR Vβ 16 were significantly lower and the expression of TCR Vβ 17 was significantly higher in patients than in controls (p<0.05 for all). Subgroup analysis showed that there were significant differences in CD4 percentages, CD4/CD8 ratio, Vβ11 and Vβ12 between the CKD and dialysis groups (p<0.05 for all).

Conclusions:

 Despite lymphocyte count and lymphocyte subsets comparable to those of healthy controls, children with CKD have an impaired TCR Vβ repertoire. This deterioration is more pronounced in dialysis patients.