Differences in the Profile of Circulating Immune Cell Subsets in Males with Type 2 Cardiorenal Syndrome versus CKD Patients without Established Cardiovascular Disease
Anila Duni,
Athanasios Kitsos,
Aris Bechlioulis,
Georgios S. Markopoulos,
Lampros Lakkas,
Gerasimos Baxevanos,
Michail Mitsis,
George Vartholomatos,
Katerina K. Naka,
Evangelia Dounousi
Affiliations
Anila Duni
Department of Nephrology, School of Health Sciences, Faculty of Medicine, University of Ioannina and University Hospital of Ioannina, GR 45500 Ioannina, Greece
Athanasios Kitsos
Department of Nephrology, School of Health Sciences, Faculty of Medicine, University of Ioannina and University Hospital of Ioannina, GR 45500 Ioannina, Greece
Aris Bechlioulis
Second Department of Cardiology, Faculty of Medicine, School of Health Sciences, University of Ioannina and University Hospital of Ioannina, GR 45500 Ioannina, Greece
Georgios S. Markopoulos
Laboratory of Haematology—Unit of Molecular Biology and Translational Flow Cytometry, University Hospital of Ioannina, GR 45500 Ioannina, Greece
Lampros Lakkas
Second Department of Cardiology, Faculty of Medicine, School of Health Sciences, University of Ioannina and University Hospital of Ioannina, GR 45500 Ioannina, Greece
Gerasimos Baxevanos
Laboratory of Haematology—Unit of Molecular Biology and Translational Flow Cytometry, University Hospital of Ioannina, GR 45500 Ioannina, Greece
Michail Mitsis
Kidney Transplant Unit, Department of Surgery, Faculty of Medicine, School of Health Sciences, University of Ioannina and University Hospital of Ioannina, GR 45500 Ioannina, Greece
George Vartholomatos
Laboratory of Haematology—Unit of Molecular Biology and Translational Flow Cytometry, University Hospital of Ioannina, GR 45500 Ioannina, Greece
Katerina K. Naka
Second Department of Cardiology, Faculty of Medicine, School of Health Sciences, University of Ioannina and University Hospital of Ioannina, GR 45500 Ioannina, Greece
Evangelia Dounousi
Department of Nephrology, School of Health Sciences, Faculty of Medicine, University of Ioannina and University Hospital of Ioannina, GR 45500 Ioannina, Greece
Maladaptive activation of the immune system plays a key role in the pathogenesis of chronic kidney disease (CKD). Our aim was to investigate differences in circulating immune cells between type 2 cardiorenal syndrome (CRS-2) patients and CKD patients without cardiovascular disease (CVD). CRS-2 patients were prospectively followed up, with the primary endpoint being all-cause and cardiovascular mortality. Method: A total of 39 stable males with CRS-2 and 24 male CKD patients matched for eGFR (CKD-EPI) were enrolled. A selected panel of immune cell subsets was measured by flow cytometry. Results: Compared to CKD patients, CRS-2 patients displayed higher levels of proinflammatory CD14++CD16+ monocytes (p = 0.04) and T regulatory cells (Tregs) (p = 0.03), lower lymphocytes (p = 0.04), and lower natural killer cells (p = 0.001). Decreased lymphocytes, T-lymphocytes, CD4+ T-cells, CD8+ T-cells, Tregs, and increased CD14++CD16+ monocytes were associated with mortality at a median follow-up of 30 months (p p = 0.004). Conclusion: Patients with CRS-2 exhibit alterations in immune cell profile compared to CKD patients of similar kidney function but without CVD. In the CRS-2 cohort, CD4+ T-lymphocytes independently predicted fatal cardiovascular events.
