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Nephrol Dial Transplant (2001) 16: 1430-1435
© 2001 European Renal Association-European Dialysis and Transplant Association

Quantitative flow cytometry shows activation of the TNF-{alpha} system but not of the IL-2 system at the single cell level in renal replacement therapy

Iza C. van Riemsdijk-van Overbeeke, Carla C. Baan, Christiaan J. Knoop, Elisabeth H. M. Loonen, Robert Zietse and Willem Weimar

Department of Internal Medicine, University Hospital Rotterdam-Dijkzigt, The Netherlands

Background. Immunological dysfunction in patients on haemodialysis may be related to imbalanced cytokine systems, such as tumour necrosis factor (TNF)-{alpha} and interleukin (IL)-2. Despite activation of these systems, haemodialysis patients show high susceptibility for infections and malignancies, and have a poor immunological reaction to T-cell-dependent antigens, like hepatitis B vaccination. In this study we have determined the activation status of the two different cytokine systems, at the single cell level, using quantitative flow cytometry.

Methods. Using fluorescein isothiocyanate- or phycoerythrin-conjugated antibodies directed against TNF-R2 (CD120b), IL-2R{alpha} (CD25) and IL-2Rß (CD122), we measured the expression of these receptors at the single cell level in order to determine the level of activation of monocytes and T-lymphocytes.

Results. Significantly higher expression of the TNF-{alpha} receptor, TNF-R2, was present on both monocytes and T-lymphocytes in patients on renal replacement therapy (RRT) compared with pre-dialysis chronic renal failure (CRF) patients and controls, indicating activation of the TNF-{alpha} system. In contrast, IL-2R expression was comparable in all groups studied, which may reflect a non-activated state of the IL-2 system.

Conclusions. The present study illustrates an activated state of the TNF-{alpha} system in patients on RRT, at the single cell level, while the IL-2 system seems to be unaffected. These findings support the hypothesis that the interaction between the TNF-{alpha} and IL-2 cytokine systems is disturbed.

Keywords: activation; chronic renal failure; IL-2; quantitative flow cytometry; renal replacement therapy; TNF-{alpha}

Correspondence and offprint requests to: Dr I. C. van Riemsdijk-van Overbeeke, Department of Internal Medicine, University Hospital Rotterdam-Dijkzigt, PO Box 2040, 3000 CA Rotterdam, The Netherlands.


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