Characteristic cytokine products of Th1 and Th2 cells in hemodialysis patients

Dysfunction of the host defense against infection in hemodialysis (HD) pati ents has major clinical and socioeconomic implications. T helper type 1 (Th 1) and type 2 (Th2) cytokines are implicated in regulating the immune respo nses and, therefore, may be involved in impaired status. The present study was designed to examine Th1 and Th2 cytokine profiles in 22 stable HD patie nts (aged 63 +/- 11 years) and 22 healthy controls (aged 60 +/- 6 years). T he T cell activity was significantly retarded in HD patients as compared wi th normal persons. The proportions of T cytotoxic/suppressor cells and natu ral killer cells were significantly higher in HD patients than in controls. In contrast, the proportions of T helper/inducer and B cells were signific antly lower in HD patients than in controls. The production of interleukin (IL) 2, which is involved in cell-mediated immune responses, and the produc tion of IL-4 and IL-10, which affect humoral immunity, were significantly l ower in patients than in controls. The production of IL-12 by macrophages a nd of interferon gamma by Th1 cells was significantly higher in HD patients than in controls. The concentration of plasma sIL-2R was significantly hig her in patients than in controls. These results suggest that both cellular immunity induced by Th1 and humoral immunity induced by Th2 decrease in HD patients, but that improved IL-12 secretion by macrophages activated natura l killer cells to produce interferon gamma, which in turn induced macrophag e activity.