Plasma levels of Th1/Th2 Type Cytokine are Associated with Change of Prolactin and GH/IGF-I in Hemodialysis Patients

Abstract

Patients undergoing chronic hemodialysis (HD) have an impaired immune system involving both B and T cell-mediated immune responses. Since T helper type 1 (Th1) and type 2 (Th2) cytokines are implicated in regulating the immune responses, while the pituitary hormones, prolactin (PRL) and growth hormone (GH) are known to be involved in the regulation of the immune response, all of them may, therefore, be involved in impaired status. The aims of the present study were to estimate the serum concentrations of Th1-Th2 cytokine, GH, insulin-like growth factor-I (IGF-I) and PRL, and to determine whether there are any correlations between the release of T-cell cytokines and disturbance of hormones in a group of patients on maintenance hemodialysis (MHD). The study included 35 HD patients (23 males and 12 females, mean age 56.8±12.8 years) and a control group of 20 age-matched healthy subjects. Baseline serum concentrations of GH/IGF-I, PRL, IL-2, sIL-2R, IFN-γ, IL-4 and IL-10 were measured in all patients and control subjects. Our results demonstrate that the fasting serum concentration of IGF-I, PRL, sIL-2R and Th1-type cytokine, including IL-2 and IFN-γ, were significantly higher in HD patients compared to the healthy subjects. GH and Th2-type cytokine including IL-4 and IL-10 levels were slightly reduced, but no significant differences were observed between HD patients and the control group. In the group of HD patients, PRL correlated directly with IFN-γ and correlated inversely with IL-10; IFN-γ correlated inversely with IL-4; and GH also correlated inversely with IGF-I and IL-4. However, IGF-I correlated directly with IL-2 and IL-10. These data suggest that the Th1/Th2 imbalance in HD patients with an increase of Th1 type cytokines, associated with the altered GH/IGF-I axis and prolactin and immuno-endocrine dysfunction, probably plays a role in an impaired immune system in HD patients.