慢性腎不全患者の免疫能に関する研究 第2報 : グアニジン化合物による免疫能抑制効果について

Abstract

To study the inhibitory effect of guanidine compounds on cellular immunity, the PHA-induced blastoid transformation of lymphocytes of patients with chronic renal failure (CRF) on hemodialysis (HD) or hemofiltration (HF), was examined, and later the stimulation index (SI) was calculated. Serum concentration of guanidine compounds was concomitantly measured. The SI was 39.80±21.70, 60.27±22.05 and 61.09±16.32 for the HD, HF and healthy control groups, respectively. Although the value for the HD group was significantly lower than that for the HF group (p<0.02) or the control group (p<0.001) were was no difference between the HF and control groups. The serum methylguanidine (MG) concentration for the HD group was 38.97 ± 18.83 µg/dl, which was significantly higher than the 23.92 11.05 µg/dl for the HF group. The SI and MG for the CRF patients were inversely correlated. From these results, MG is considered to be one of the uremic toxins that inhibit cellular immunity. Therefore, HF seems to be a better mode of therapy in that it improves the cellular immunity of CRF patients by reducing the MG.