Editorial: Immunosenescence and Immunoexhaustion in Chronic Kidney Disease and Renal Transplantation

Stangou, Μaria; Fylaktou, Asimina; Ivanova-Shivarova, Milena; Théodorou, Ioannis

doi:10.3389/fmed.2022.874581

Cited by 5 publications

(5 citation statements)

References 10 publications

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“…With their ability to produce an efficient immune response being significantly compromised, it is not a surprise that RTRs have a higher incidence of SARS-CoV-2 infection compared to the general population, as well as an increased risk of adverse COVID-19 outcomes [65][66][67][68][69]. A worse disease course is definitely anticipated during the early posttransplantation period and among recipients of deceased donor transplants [68].…”

Section: Covid-19 Infection In Renal Transplant Recipientsmentioning

confidence: 99%

“…Many researchers have pointed out that the prognosis in hospitalized RTRs is poorer, the clinical progression faster, and the mortality rates significantly higher, while in a considerable proportion of them, the disease is complicated with acute kidney injury (AKI). Potential mechanisms leading to the latter vary from direct parenchymal damage and inflammationinduced microangiopathy to acute rejection (due to the reduction in immunosuppressants to subtherapeutic levels) and calcineurin inhibitor (CNI) toxicity (resulting from their interaction with other drugs) [65][66][67][68][69]. The clinical image of the disease may differ from that in healthy individuals, with notably smaller percentages of RTRs being reported with fever and a greater proportion of them experiencing malaise and respiratory and gastrointestinal symptoms [70].…”

Section: Covid-19 Infection In Renal Transplant Recipientsmentioning

confidence: 99%

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COVID-19 Infection and Response to Vaccination in Chronic Kidney Disease and Renal Transplantation: A Brief Presentation

Stai

Λιούλιος

Christodoulou

et al. 2022

Life

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Chronic kidney disease (CKD) is associated with phenotypic and functional changes in the immune system, followed by detrimental clinical consequences, such as severe infections and defective response to vaccination. Two years of the pandemic, due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), have undoubtedly changed the world; however, all efforts to confront infection and provide new generation vaccines tremendously improved our understanding of the mechanisms of the immune response against infections and after vaccination. Humoral and cellular responses to vaccines, including mRNA vaccines, are apparently affected in CKD patients, as elimination of recent thymic emigrant and naïve lymphocytes and regulatory T-cells, together with contraction of T-cell repertoire and homeostatic proliferation rate, which characterized CKD patients are responsible for impaired immune activation. Successful renal transplantation will restore some of these changes, although several epigenetic changes are irreversible and even accelerated by the induction of immunosuppression. Response to vaccination is definitely impaired among both CKD and RT patients. In the present review, we analyzed the differences in immune response after vaccination between these patients and healthy individuals and depicted specific parameters, such as alterations in the immune system, predisposing to this deficient response.

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Section: Covid-19 Infection In Renal Transplant Recipientsmentioning

confidence: 99%

Section: Covid-19 Infection In Renal Transplant Recipientsmentioning

confidence: 99%

COVID-19 Infection and Response to Vaccination in Chronic Kidney Disease and Renal Transplantation: A Brief Presentation

Stai

Λιούλιος

Christodoulou

et al. 2022

Life

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“…Current evidence suggests that elderly patients with COVID-19 infection are more likely to have a higher inflammatory state, with higher CRP levels, lymphopenia, neutrophilia and increased findings of multi lobe lung lesions on Computed Tomography scanning compared to their younger counterparts [ 37 ]. It is established that elderly patients and those with kidney failure have higher numbers of CD28 and CD4 null cells and advanced differentiated cells, which may result in the increased likelihood of cytokine storm and acute lung injury [ 38 ]. This may also be, in part, secondary to impaired airway clearance and reduced lung reserves in the elderly population affected by comorbidities and frailty.…”

Section: Risk Factors For Poor Clinical Outcomes In Elderly Haemodial...mentioning

confidence: 99%

COVID-19 in Elderly Patients Receiving Haemodialysis: A Current Review

McDonnell

Kalra

et al. 2023

Biomedicines

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There is an increased incidence of elderly adults diagnosed with kidney failure as our global aging population continues to expand. Hence, the number of elderly adults indicated for kidney replacement therapy is also increasing simultaneously. Haemodialysis initiation is more commonly observed in comparison to kidney transplantation and peritoneal dialysis for the elderly. The onset of the coronavirus 2019 (COVID-19) pandemic brought new paradigms and insights for the care of this patient population. Elderly patients receiving haemodialysis have been identified as high-risk groups for poor COVID-19 outcomes. Age, immunosenescence, impaired response to COVID-19 vaccination, increased exposure to sources of COVID-19 infection and thrombotic risks during dialysis are key factors which demonstrated significant associations with COVID-19 incidence, severity and mortality for this patient group. Recent findings suggest that preventative measures such as regular screening and, if needed, isolation in COVID-19-positive cases, alongside the fulfillment of COVID-19 vaccination programs is an integral strategy to reduce the number of COVID-19 cases and consequential complications from COVID-19, particularly for high-risk groups such as elderly haemodialysis patients. The COVID-19 pandemic brought about the rapid development and repurposing of a number of medications to treat patients in the viral and inflammatory stages of their disease. However, elderly haemodialysis patients were grossly unrepresented in many of these trials. We review the evidence for contemporary treatments for COVID-19 in this population to provide clinicians with an up-to-date guide. We hope our article increases awareness on the associations and impact of COVID-19 for the elderly haemodialysis population, and encourage research efforts to address knowledge gaps in this topical area.

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“…Kidney transplant recipients are a very specific population of patients due to their prolonged use of immunosuppressive agents, history of long-lasting chronic kidney disease and, in most cases, a history of dialysis therapy before kidney transplantation [ 24 ]. All of these factors undoubtedly affect the patient‘s endocrine system and immune response [ 25 , 26 , 27 ].…”

Section: Introductionmentioning

confidence: 99%

Endobiogenic Biology of Function Indices in a Cohort of Kidney Transplant Recipients

Mačionienė,

Serapinas,

Miglinas

2024

Medicina

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Background and Objectives: Endobiogeny is a global systems approach to human biology based on the concept that the endocrine system manages the metabolism. Biology of function (BoF) indices are diagnostic tools in endobiogenic medicine that reflect the action of the endocrine system on the cells and the metabolic activity of an organism. Kidney transplant recipients are a very specific patient population due to their constant use of immunosuppressive agents such as steroids and anamnesis of chronic kidney disease. The aim of this study was to assess the tendencies of endobiogenic BoF indices in a kidney transplant recipient population and to determine the relationship between BoF index values and histology-proven kidney transplant rejection. Materials and Methods: A total of 117 kidney transplant recipients undergoing surveillance or indication allograft biopsy were included in this study. Endobiogenic BoF indices were calculated from complete blood count tests taken before the kidney biopsy. Histology samples were evaluated by an experienced pathologist according to the Banff classification system. Clinical and follow-up data were collected from an electronic patient medical record system. Results: Overall, <35% of the patients had BoF index values assumed to be normal, according to the general population data. Additionally, >50% of the patients had lower-than-normal adaptation, leucocyte mobilization, genital, and adjusted genital ratio indices, while the Cata-Ana, genito-thyroid ratio, adrenal gland, and cortisol indices were increased in >50% of the transplant recipients. The adaptation index was significantly higher in patients with biopsy-proven transplant rejection and demonstrated an AUC value of 0.649 (95%CI 0.540–0.759) for discriminating rejectors from patients without transplant rejection. Conclusions: Most of the kidney transplant recipients had abnormal BoF index values, reflecting increased corticotropic effects on their cells. The adaptation index distinguished patients with biopsy-proven transplant rejection from those without it.

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Editorial: Immunosenescence and Immunoexhaustion in Chronic Kidney Disease and Renal Transplantation

Cited by 5 publications

References 10 publications

COVID-19 Infection and Response to Vaccination in Chronic Kidney Disease and Renal Transplantation: A Brief Presentation

COVID-19 Infection and Response to Vaccination in Chronic Kidney Disease and Renal Transplantation: A Brief Presentation

COVID-19 in Elderly Patients Receiving Haemodialysis: A Current Review

Endobiogenic Biology of Function Indices in a Cohort of Kidney Transplant Recipients

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