This analysis shows altered T and B cell profiles in end-stage renal disease, highlighting links to uremic toxins and short-chain fatty acids.
Recent studies indicate that changes in the gut microbiota modulate the host's immune system by modulating bacterial metabolism. Meanwhile, the features of this association in patients with end-stage renal disease remain largely unexplored. The aim of this study was to analyze the features in the subpopulation composition of T and B cells in patients on maintenance hemodialysis, as well as to assess the relationship of the identified changes with the serum levels of microbial-derived uremic toxins and the fecal short-chain fatty acids content. The serum levels of trimethylamine-N-oxide, indoxyl sulfate, and p-cresyl sulfate, as well as the total content and profile of certain fecal short-chain fatty acids, were evaluated in 30 patients on maintenance hemodialysis and 30 subjects with normal renal function, comparable in basic clinical and demographic characteristics. The results were compared with the phenotype of T and B cells analyzed by flow cytometry. The results revealed that significantly increased concentrations of all the studied microbial-derived uremic toxins and reduced levels of short-chain fatty acids in patients on maintenance hemodialysis, significantly correlated with a decrease in the absolute and/or relative content and a violation of the subpopulation composition of CD3+ T cells, including CD4+ T-helpers and CD8+ cytotoxic T cells, as well as CD19+ B cells. Thus, gut bacteria metabolites seem to be a link between uremic dysbiosis and adaptive immune responses in end-stage renal disease.
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Pyatchenkov et al. (2025) studied this question.