Decreased Number of CD14+TLR4+ Monocytes and Their Impaired Cytokine Responses to Lipopolysaccharide in Patients with Chronic Kidney Disease

摘要

This study aimed to examine the number of circulating Toll-like receptor 4(TLR4) + CD14+ monocytes in patients with different stages of chronic kidney disease(CKD), their responses to lipopolysaccharide(LPS), and to explore the potential association of the number of TLR4+CD14+ monocytes with clinical laboratory measures. The numbers of TLR4+CD14+, LPS-stimulated TNF-?+CD14+ and interleukin(IL)-6+CD14+ monocytes were determined by flow cytometry in 9 patients with stage 3 CKD, 11 with stage 4 CKD, 16 with stage 5 CKD, and 19 healthy controls(HCs). Their laboratory tests were performed by routine methods and the potential association among these measures was analyzed by Pearson's correlation analysis. The numbers of CD14+, CD14+TLR4+, LPSstimulated TNF-?+CD14+ and IL-6+CD14+ monocytes in patients with CKD were significantly less than those of HCs(all P<0.05), and were negatively associated with patient disease severity. The number of CD14+TLR4+ monocytes was positively correlated with estimated glomerular filtration rate(e GFR, P<0.001) and the levels of hematocrit(P<0.01), but negatively correlated with the levels of blood urine nitrogen, serum creatinine, and C-reactive protein(P<0.001 for all), in the CKD patients. Our data indicate that significant reduction in the number of TLR4+ monocytes and their impaired responses to LPS may be associated with the progression of CKD in Chinese patients.