Progressive loss of renal function is associated with a dysregulation of circulating T cells that may underlie their impaired T-cell immunity. Here we tested whether end-stage renal disease (ESRD)-related T-cell alterations are compatible with the concept of premature immunological aging. Younger patients (25-45 years old) with ESRD were found to resemble older healthy controls (60-80 years old) as they had a significant loss of naive T cells and a relative increase of memory T cells showing progressive terminal differentiation. A significant decrease in the content of T-cell receptor excision circles and telomere length in patients with ESRD confirmed these phenotypic data. The loss of naive T cells in patients with ESRD was associated with an excessive age-related decrease of recent thymic emigrants, indicating a premature decline in thymic function. Additionally, increased homeostatic proliferation of naive T cells was found in patients with ESRD, similar to that of older healthy individuals, with an increased susceptibility for activation-induced apoptosis. Therefore, both decreased thymic output and increased susceptibility of naive T cells for apoptosis may play a role in the loss of naive T cells in ESRD patients. Thus, our results are compatible with premature aging of the T-cell system of patients with ESRD comparable with that of healthy individuals 20-30 years older.

Additional Metadata
Keywords aging, chronic kidney disease, clinical immunology, lymphocytes, telomeres
Persistent URL dx.doi.org/10.1038/ki.2011.110, hdl.handle.net/1765/33369
Citation
Betjes, M.G.H., Langerak, A.W., van der Spek, A., de Wit, E.A., & Litjens, N.H.R.. (2011). Premature aging of circulating T cells in patients with end-stage renal disease. Kidney International, 80(2), 208–217. doi:10.1038/ki.2011.110