Introduction:
CKD-associated pruritus (CKD-aP) is a distressing condition with an unknown pathogenesis. Neutrophils have been identified as significant independent risk factors for CKD. Immature neutrophils are known to promote inflammation, while mature neutrophils are immunosuppressive. Despite their known ability to disrupt skin homeostasis through NETosis and immune modulation, their specific involvement in CKD-aP is unexplored. This study aims to investigate the heterogeneous distribution of neutrophils in CKD-aP patients
Methods:
A total 25 CKD-aP patients and 15 healthy controls (HC) were recruited for the study. Peripheral blood samples (5 mL each) were collected and processed for neutrophil isolation. The isolated neutrophils were characterized for CD11b expression and stained for CD10 and CD16. Flow cytometry was used to analyze neutrophil (CD11b+) heterogeneity. identifying immature (CD10⁻CD16-) and mature (CD10⁺ CD16-) neutrophil populations followed by their potential of NETosis (CD10+CD16+).
Results:
The mean age of CKD-aP patients and healthy controls was 47.73±13.75 and 44.60±18.31 years, respectively. The recorded itch score for CKD-aP patients was 7.0±1.19, with a mean eGFR of 27±7.05 mL/min/1.73 m2. The mean percentage of CD11b⁺ neutrophils was 68±10.25% in CKD-aP patients and 42.51±21.15% in HC. The percentage of immature neutrophils was significantly higher in CKD-aP patients compared to HC (CKD-aP: 35.10±5.14% vs HC: 8.51±6.98%; p<0.01). Further stratification revealed almost similar frequency of CD16⁺ cells (CKD-aP: 2.55±1.96% vs HC: 2.77±1.56%, p=ns), while the percentage of CD10⁺ cells was higher in CKD-aP patients compared to HC (CKD-aP: 2.85±1.50% vs HC: 1.12±0.64%; p<0.01). However, the frequency of NETosis mature neutrophil is significantly higher in CKD-ap compared to the HC (CKD-aP: 75.02±20.60% vs HC: 31.99±10.41%; p<0.01).
Conclusions:
This study reveals a notable accumulation of immature neutrophils in CKD-aP patients, reflecting heightened inflammation or immune response. While CD16 levels are unchanged, suggesting that neutrophil functions such as phagocytosis are not compromised, the notable shift in CD10 expression reveals a polarization towards inflammation promotion and NETosis.
I have no potential conflict of interest to disclose.
I did not use generative AI and AI-assisted technologies in the writing process.