{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T23:58:18Z","timestamp":1785455898508,"version":"3.56.0"},"reference-count":24,"publisher":"Springer Science and Business Media LLC","issue":"9","license":[{"start":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T00:00:00Z","timestamp":1774396800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T00:00:00Z","timestamp":1774396800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100016003","name":"Istanbul \u00dcniversitesi-Cerrahpasa","doi-asserted-by":"publisher","award":["TTU-2020-35357"],"award-info":[{"award-number":["TTU-2020-35357"]}],"id":[{"id":"10.13039\/501100016003","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Istanbul University"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Pediatr Nephrol"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Chronic kidney disease (CKD), characterized by chronic inflammation and uremic toxicity, represents a state of premature immune aging. However, data on T-cell receptor (TCR) repertoire alterations in pediatric CKD are limited. The TCR variable beta (V\u03b2) region defines distinct T-cell subfamilies generated by V(D)J recombination and reflects T-cell repertoire diversity and clonal composition. Alterations in TCR V\u03b2 distribution indicate repertoire remodeling associated with chronic antigenic stimulation and immune aging beyond quantitative lymphocyte changes. This study aimed to characterize TCR V\u03b2 family repertoire in children with advanced CKD and explore their associations with clinical and biochemical parameters.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      In this single-center, cross-sectional study, 35 children with CKD stages 3b\u20135 (21 non-dialysis, 14 dialysis) and 15 age- and sex-matched healthy controls were enrolled. Peripheral blood lymphocyte subsets and TCR V\u03b21\u2013V\u03b223 distributions were assessed by flow cytometry and compared with clinical and laboratory measures. Group comparisons were performed using the Mann\u2013Whitney\n                      <jats:italic>U<\/jats:italic>\n                      test, and associations were assessed using Spearman correlation analysis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Children with CKD exhibited a skewed TCR V\u03b2 repertoire, with reduced expression of V\u03b29 and V\u03b211 and increased V\u03b217 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.041, 0.001, 0.014, respectively) with corresponding moderate-to-large effect sizes (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.37,\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.61, and\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.44). Dialysis patients showed lower V\u03b211 and higher V\u03b212 expression compared with non-dialysis patients (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.034 and\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.048), with large effect sizes (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.68 and\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.66). Reduced V\u03b29 correlated with low BMI and higher proteinuria, and reduced V\u03b211 correlated with hypoalbuminemia, whereas elevated V\u03b212 was associated with higher CRP and creatinine levels. Total lymphocyte counts were preserved, although dialysis patients demonstrated a higher CD4\/CD8 ratio.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Pediatric CKD is associated with selective and non-uniform remodeling of the T-cell repertoire, reflecting premature immune senescence. The associations between TCR V\u03b2 alterations, inflammation, and nutritional markers suggest synergistic effects of uremic toxicity and protein-energy imbalance on immune aging, warranting larger mechanistic studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Graphical Abstract<\/jats:title>\n                    <jats:p>A higher resolution version of the\u00a0\u00a0Graphical abstract is available as Supplementary information.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00467-026-07267-w","type":"journal-article","created":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T23:58:09Z","timestamp":1774396689000},"page":"2923-2930","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["T-cell receptor V\u03b2 repertoire skewing reflects premature immune senescence in children with chronic kidney disease"],"prefix":"10.1007","volume":"41","author":[{"given":"Emine","family":"\u00dclgen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seha","family":"Sayg\u0131l\u0131","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ay\u00e7a","family":"K\u0131yk\u0131m","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nihan","family":"Burtecene","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esra Karaba\u011f","family":"Y\u0131lmaz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ay\u015fe","family":"A\u011fba\u015f","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3420-9756","authenticated-orcid":false,"given":"Nur","family":"Canpolat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,3,25]]},"reference":[{"key":"7267_CR1","doi-asserted-by":"publisher","first-page":"208","DOI":"10.1038\/ki.2011.110","volume":"80","author":"MGH Betjes","year":"2011","unstructured":"Betjes MGH, Langerak AW, van der Spek A, de Wit EA, Litjens NHR (2011) Premature aging of circulating T cells in patients with end-stage renal disease. 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Written informed consent was obtained from all participants or legal guardians.","order":1,"name":"Ethics","label":"Ethics approval and consent","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Declarations"}}]}}