Résumé
Patients with chronic renal failure [CRF] on regular hemodialysis [HD] often present with signs of immunodeficiency. In the present study, we investigated the in vitro proliferation and production of IL-2 and IFN-gamma of peripheral blood mononuclear cells [PBMC] in response to phytohemagglutinin [PHA] in 18 patients with CRF regularly hemodialysed compared to 10 normal individuals [control group]. Before dialysis the mean proliferative response [SI] of PBMC from patients was significantly lower than that of control group, whereas the spontaneous proliferation of PBMC was significantly higher in patients before dialysis than in normal subjects. These proliferative responses in patients were normalized after a single session. Regarding the cytokines, both IL-2 and IFN-gamma were secreted by patients PBMC in levels significantly higher than that by normal PBMC, whereas the cellular contents of these cytokines were comparable in the two groups. A single session of HD reduced both the released and the cellular contents of these cytokines. From these results it can be concluded that, the apparent in vitro reduced proliferative response of PBNC to PHA is, at least partly, due to in vivo chronic activation of these cells by uremic toxins and this cellular defect is reversible as it was corrected by a single session of HD