About this Research Topic
Chronic kidney disease (CKD) either at pre-dialysis stages or after renal replacement treatment is widely accepted as a chronic inflammatory condition and is uniquely characterized by both reduced immune and increased inflammatory activity. Deficiencies in innate and adaptive immunity are present in CKD because of increasing production and accumulation of uremic toxins, O2 free radicals, cytokines, FGF23, but also due to extracorporeal circulation itself. Changes in adaptive immunity affect both B and T lymphocytes, with a shift to the immature and prodromal stages of B cell subpopulations, and simultaneously an increased proportion of terminally differentiated T cells (reduction of telomeres, increased of CD28- and CD57- subpopulations).
All the above changes consist of a senescent and/or exhausted profile often seen in advanced ageing. Furthermore, they reflect the impact of CKD on the immune system which can lead to both immunosenescence and immunoexhaustion. Such clinical consequences are critical, and may include reduced response to immunization, increased susceptibility and severity of infections, incidence of neoplasms secondary to viral infections, and increased cardiovascular risk.
Ultimately, increased morbidity and mortality is a clear consequence. However, possibly even more imperative is how these sustained immunological deficiencies will influence a kidney transplant. What are their effects on graft function and renal transplant outcome and vice versa? Can transplantation restore existing damage to the immune system and change the immunosenescent and immunoexausting profile of these patients closer that of their age?
This Research Topic aims to elucidate mechanisms which may lead to specific immunological deficiencies in CKD, describe changes in innate and adaptive immunity and investigate their clinical consequences and possible influence on morbidity and mortality.
We call for investigators to participate with Original Research articles, such as basic research and clinical investigations, Opinion, Perspective, and Reviews, including but not limited to the following aspects:
1. Mechanisms of senescence and immunosenescence in ageing and chronic kidney disease
2. Mechanisms of immunoexhaustion in ageing and chronic kidney disease
3. Molecular hallmarks of immunosenescence and immunoexhaustion
4. Clinical significance of immunosenescence and immunoexhaustion in CKD patients
5. Mechanisms of atheromatosis in CKD, the effect of immunological reactions
6. Immune system in Hemodialysis and Peritoneal Dialysis
7. Impact of patients’ immunological profile in renal transplant outcome
8. Possible restoration of immune system after kidney transplantation
Keywords: Immunosenescence, Immunoexhaustion, Chronic Kidney Disease, Renal Transplantation, lymphocytes, atheromatosis
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