Potential role of costimulatory pathways in immune dysfunction in hemodialysis patients Article Swipe
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· 2016
· Open Access
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· DOI: https://doi.org/10.1111/hdi.12442
· OA: W2471987962
Potential role of costimulatory pathways in immune dysfunction in hemodialysis patientsTo the Editor:We read with interest the paper by Mathew et al. who investigated the role of T-regulatory cells in the immune response to HBV vaccination in patients undergoing hemodialysis (HD). 1 This is a very important topic, since response to vaccines is commonly considered an expression of immune status in HD.The authors, in agreement with previous reports, demonstrated that in HD there is a low rate of response to vaccine, but they did not find any significant difference in T-regulatory cell number between healthy controls and HD subjects.We think that this negative result could depend by the fact that immune dysfunction in HD patients involves alterations of various types of immune cells, including polymorphonuclear leukocytes, monocytes, natural killer cells, B and T lymphocytes 2,3 and probably the simple study of the number of T-regulatory cells and their subtypes is not sufficient to describe this condition.Indeed, in this complex picture T cell dysfunction can occur at different levels.In this regards, in the last years, many studies have demonstrated that co-stimulatory signal alterations may play a role in determining immunodeficiency in HD.
