Treg/Th17 Functional Disequilibrium in Chinese Uremia on Hemodialysis: A Link between Calcification and Cardiovascular Disease

Figures & data

Table 1.  Basic clinical and laboratory characteristics of the study population.

	Normal control (n = 20)	MHD group1 (n = 36)	MHD group2 (n = 30)
Age (years)	44.00 ± 9.00	56.00 ± 13.00	47.00 ± 11.00
Sex (male:female)	10:10	24:12	16:14
Months since initiating dialysis	—	30.00 ± 23.00	30.00 ± 17.00
Risk factors
Smoking	4 (20%)	11 (31%)	8 (27%)
Diabetes mellitus	0 (0%)	6 (17%)	4 (13%)
Hyperlipidemia	2 (10%)	12 (33%)	8 (27%)
Systolic blood pressure (mmHg)	120.44 ± 8.88	149.10 ± 15.60	141.15 ± 16.88
Diastolic blood pressure (mmHg)	72.94 ± 6.48	83.70 ± 9.83	86.31 ± 9.22
Body mass index	20.99 ± 1.81	21.75 ± 3.39	22.09 ± 1.71
Hemoglobin (g/L)	130.56 ± 11.08	93.63 ± 22.81	105.62 ± 14.14
Albumin (g/L)	37.47 ± 5.56	35.47 ± 4.61	37.69 ± 6.64
Other laboratory parameters
Blood urea nitrogen (mmol/L)	5.86 ± 0.90	22.68 ± 8.94	20.26 ± 8.91
Serum creatinine (μmol/L)	89.5 ± 15.21	728.54 ± 288.06	710.88 ± 249.38
Medications
rHu-EPO	0 (0%)	22 (61%)	20 (67%)
Beta-blockers	0 (0%)	10 (28%)	10 (33%)
Statins	2 (10%)	12 (33%)	8 (27%)

Notes: Values are given as mean ± SD or number. MHD group1, group of uremia patients who had experienced CVD after HD; MHD group2, group of uremia patients who had not experienced CVD after HD.

Table 2.  Assessment of heart function in the subgroup of uremia patients on HD.

	NYHA I–II (n = 38)	NYHA III–IV (n = 28)
Sex (male:female)	23:15	16:12
LVEDd (mm)	52.91 ± 4.56	59.70 ± 3.39**
Ejection fraction (%)	51.95 ± 3.21	44.77 ± 7.68**
Fractional shortening (%)	23.79 ± 2.08	16.86 ± 1.82**
LV mass index (g/m^2)	121.34 ± 11.30	189.00 ± 35.38**

Notes: LVEDd, left ventricular end-diastolic diameter; LV, left ventricular.

**p < 0.05 versus New York Heart Association (NYHA) I–II group.

Figure 1.  Frequency of the Treg and Th17 cells among groups. The representative photographs of flow cytometry analysis of Treg and Th17 cell surface expression and intracellular staining are without and with rhBP-2 from MHD group1 (A and D, respectively), MHD group2 (B and E, respectively), and normal control group (C and F, respectively).

Table 3.  Comparison of Treg and Th17 cell frequencies among groups.

	Control group (without rhBMP-2)			100 ng/mL rhBMP-2
	MHD group1 (n = 36)	MHD group2 (n = 30)	Normal control (n = 20)	MHD group1 (n = 36)	MHD group2 (n = 30)	Normal control (n = 20)
Treg cell frequencies	5.92 ± 3.29**	4.46 ± 1.79**	0.32 ± 0.44	6.15 ± 2.38**	6.14 ± 1.80**	0.82 ± 0.81
Th17 cell frequencies	35.98 ± 8.85**	19.64 ± 5.97**,*	1.12 ± 1.52	52.27 ± 9.62**	34.05 ± 5.67**,*	3.26 ± 1.21
Frequency ratio of Treg and Th17	15.35 ± 4.86**	20.67 ± 6.28**,*	26.31 ± 2.26	11.77 ± 2.47**	18.03 ± 3.17**,*	25.15 ± 2.26

Notes: Values are given as mean ± SD.

**p < 0.05 versus normal control; *p < 0.05 MHD group1 versus MHD group2.

Table 4.  mRNA expression of Foxp3 and ROR-γt among groups.

	Control group (without rhBMP-2)			100 ng/mL rhBMP-2
	MHD group1 (n = 36)	MHD group2 (n = 30)	Normal control (n = 20)	MHD group1 (n = 36)	MHD group2 (n = 30)	Normal control (n = 20)
Foxp3	3.37 ± 0.03**	3.12 ± 0.69**	0.96 ± 0.07	3.51 ± 0.12**	3.46 ± 0.69**,*	1.12 ± 0.38
ROR-γt	4.39 ± 1.21**	2.20 ± 0.19**,*	0.33 ± 0.01	11.70 ± 1.64**	3.05 ± 0.13**,*	0.36 ± 0.27
Expression ratio of Foxp3 and ROR-γt	0.77 ± 0.04**	1.42 ± 0.71**,*	3.20 ± 0.37	0.30 ± 0.07**	1.14 ± 0.53**,*	3.09 ± 0.03

Notes: Values are given as mean ± SD.

**p < 0.05 versus normal control; *p < 0.05 MHD group1 versus MHD group2.

Table 5.  Levels of IL-10 and IL-17 among groups.

	Control group (without rhBMP-2)			100 ng/mL rhBMP-2
	MHD group1 (n = 36)	MHD group2 (n = 30)	Normal control (n = 20)	MHD group1 (n = 36)	MHD group2 (n = 30)	Normal control (n = 20)
IL-10 (pg/mL)	22.53 ± 2.47**	22.39 ± 1.46**	11.31 ± 1.77	23.63 ± 1.46**	23.44 ± 1.71**,*	11.89 ± 0.34
IL-17 (pg/mL)	56.43 ± 8.85**	49.91 ± 1.48**,*	12.07 ± 2.26	86.29 ± 6.01**	68.53 ± 5.27**,*	13.06 ± 1.17

Notes: Values are given as mean ± SD. **p < 0.05 versus normal control; *p < 0.05 MHD group1 versus MHD group2.