A new mechanism of humoral immunodepression in chronic renal failure and its importance to dialysis and transplantation.

P K Donnelly, B K Shenton, A M Alomran, D M Francis, G Proud, R M Taylor
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Abstract

Whilst chronic renal failure (CRF) patients are known to have an impaired immune response the explanation is unclear. We investigated the immunosuppressive effect of plasma from CRF patients on an in vitro assay of normal lymphocyte function. One hundred and sixty regular dialysis patients had significantly greater plasma suppressive activity (PSA) than that of normal healthy subjects. PSA decreased after haemodialysis but increased after blood transfusion. Renal allograft recipients with low PSA were more likely to have accelerated rejection. Assay of the functional capacity of plasma for inhibiting protease (e.g. plasmin, thrombin, trypsin) suggest that high PSA is associated with the excess formation of protease-inhibitor complexes and liberation of immunoregulatory peptide (less than 10,000 daltons).

慢性肾衰竭体液免疫抑制的新机制及其对透析和移植的重要性。
虽然慢性肾衰竭(CRF)患者已知免疫反应受损,但解释尚不清楚。我们研究了CRF患者血浆对体外正常淋巴细胞功能的免疫抑制作用。160例定期透析患者的血浆抑制活性(PSA)明显高于正常健康人。血液透析后PSA降低,输血后PSA升高。低PSA的肾移植受者更有可能加速排斥反应。血浆抑制蛋白酶(如纤溶酶、凝血酶、胰蛋白酶)的功能能力测定表明,高PSA与蛋白酶抑制剂复合物的过量形成和免疫调节肽的释放(小于10,000道尔顿)有关。
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