{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T16:02:12Z","timestamp":1790870532648,"version":"4.1.0"},"reference-count":114,"publisher":"MDPI AG","issue":"13","license":[{"start":{"date-parts":[[2024,6,25]],"date-time":"2024-06-25T00:00:00Z","timestamp":1719273600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>It is widely known that diabetes mellitus negatively impacts both the innate immunity (the inflammatory response) and the acquired immunity (the humoral and cellular immune responses). Many patients with diabetes go on to develop chronic kidney disease, which will necessitate hemodialysis. In turn, long-term chronic hemodialysis generates an additional chronic inflammatory response and impairs acquired immunity. The purpose of this paper is to outline and compare the mechanisms that are the basis of the constant aggression towards self-components that affects patients with diabetes on hemodialysis, in order to find possible new therapeutic ways to improve the functionality of the immune system. Our study will take a detailed look at the mechanisms of endothelial alteration in diabetes and hemodialysis, at the mechanisms of inflammatory generation and signaling at different levels and also at the mechanisms of inflammation-induced insulin resistance. It will also discuss the alterations in leukocyte chemotaxis, antigen recognition and the dysfunctionalities in neutrophils and macrophages. Regarding acquired immunity, we will outline the behavioral alterations of T and B lymphocytes induced by diabetes mellitus and chronic hemodialysis.<\/jats:p>","DOI":"10.3390\/jcm13133687","type":"journal-article","created":{"date-parts":[[2024,6,25]],"date-time":"2024-06-25T12:46:56Z","timestamp":1719319616000},"page":"3687","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["The Complex Immunological Alterations in Patients with Type 2 Diabetes Mellitus on Hemodialysis"],"prefix":"10.3390","volume":"13","author":[{"given":"Maria-Florina","family":"Trandafir","sequence":"first","affiliation":[{"name":"Pathophysiology and Immunology Department, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 020021 Bucharest, Romania"},{"name":"Doctoral School, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 020021 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Octavian Ionel","family":"Savu","sequence":"additional","affiliation":[{"name":"Doctoral School, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 020021 Bucharest, Romania"},{"name":"\u201cN. C. Paulescu\u201d National Institute of Diabetes, Nutrition and Metabolic Diseases, 020475 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mihaela","family":"Gheorghiu","sequence":"additional","affiliation":[{"name":"Pathophysiology and Immunology Department, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 020021 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,6,25]]},"reference":[{"key":"ref_1","unstructured":"Aguirre, F., Brown, A., Cho, N.H., Dahlquist, G., Dodd, S., Dunning, T., Hirst, S.M., Hwang, C., Magliano, D., and Patterson, C. (2013). IDF Diabetes Atlas, International Diabetes Federation. [6th ed.]."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1111\/imr.12257","article-title":"Acquired immunodeficiencies and tuberculosis: Focus on HIV\/AIDS and diabetes mellitus","volume":"264","author":"Ronacher","year":"2015","journal-title":"Immunol. Rev."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Restrepo, B.I. (2016). Diabetes and Tuberculosis. Microbiol. Spectr.","DOI":"10.1128\/microbiolspec.TNMI7-0023-2016"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1016\/j.ebiom.2018.05.011","article-title":"Patients with concurrent tuberculosis and diabetes have a pro-atherogenic plasma lipid profile","volume":"32","author":"Vrieling","year":"2018","journal-title":"EBioMedicine"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1999","DOI":"10.1038\/s41598-017-01767-4","article-title":"Systems immunology of diabetes-tuberculosis comorbidity reveals signatures of disease complications","volume":"7","author":"Fukutani","year":"2017","journal-title":"Sci. Rep."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"2251","DOI":"10.2337\/dc06-2417","article-title":"Type 2 diabetes and pneumonia outcomes: A population-based cohort study","volume":"30","author":"Kornum","year":"2007","journal-title":"Diabetes Care"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1642","DOI":"10.1086\/425615","article-title":"The burden of community-acquired pneumonia in seniors: Results of a population-based study","volume":"39","author":"Jackson","year":"2004","journal-title":"Clin. Infect. Dis."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1007\/s00125-006-0570-3","article-title":"Influence of diabetes and hyperglycaemia on infectious disease hospitalisation and outcome","volume":"50","author":"Benfield","year":"2007","journal-title":"Diabetologia"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"e000181","DOI":"10.1136\/bmjdrc-2015-000181","article-title":"Diabetes hinders community-acquired pneumonia outcomes in hospitalized patients","volume":"4","author":"Martins","year":"2016","journal-title":"BMJ Open Diabetes Res. Care"},{"key":"ref_10","first-page":"129","article-title":"Urinary tract infections in patients with type 2 diabetes mellitus: Review of prevalence, diagnosis, and management","volume":"8","author":"Nitzan","year":"2015","journal-title":"Diabetes Metab. Syndr. Obes."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1778","DOI":"10.2337\/diacare.25.10.1778","article-title":"Diabetes and the risk of acute urinary tract infection among postmenopausal women","volume":"25","author":"Boyko","year":"2002","journal-title":"Diabetes Care"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"788","DOI":"10.1002\/jhm.2267","article-title":"Comparison of the microbiology and antibiotic treatment among diabetic and nondiabetic patients hospitalized for cellulitis or cutaneous abscess","volume":"9","author":"Jenkins","year":"2014","journal-title":"J. Hosp. Med."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"S27","DOI":"10.1016\/j.cmi.2015.03.024","article-title":"Pathophysiology and burden of infection in patients with diabetes mellitus and peripheral vascular disease: Focus on skin and soft-tissue infections","volume":"21","author":"Dryden","year":"2015","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Suaya, J.A., Eisenberg, D.F., Fang, C., and Miller, L.G. (2013). Skin and soft tissue infections and associated complications among commercially insured patients aged 0-64 years with and without diabetes in the U.S.. PLoS ONE, 8.","DOI":"10.1371\/journal.pone.0060057"},{"key":"ref_15","unstructured":"Levick, J.R. (2003). An Introduction to Cardiovascular Physiology, Distributed in the United States of America by Oxford University Press. [4th ed.]."},{"key":"ref_16","unstructured":"International Diabetes Federation (2024, May 13). IDF Clinical Practice Recommendations for Managing Type 2 Diabetes in Primary Care. Available online: https:\/\/idf.org\/."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1038\/nrm2327","article-title":"Mechanisms of disease: Molecular and metabolic mechanisms of insulin resistance and beta-cell failure in type 2 diabetes","volume":"9","author":"Muoio","year":"2008","journal-title":"Nat. Rev. Mol. Cell Biol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"174","DOI":"10.4103\/ajm.ajm_53_20","article-title":"Pathophysiology of diabetes: An overview","volume":"10","author":"Banday","year":"2020","journal-title":"Avicenna J. Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"2735","DOI":"10.1161\/CIRCULATIONAHA.105.169404","article-title":"Diagnosis and management of the metabolic syndrome: An American Heart Association\/National Heart, Lung, and Blood Institute Scientific Statement","volume":"112","author":"Grundy","year":"2005","journal-title":"Circulation"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1016\/S1359-6101(03)00052-2","article-title":"Insulin resistance in adipose tissue: Direct and indirect effects of tumor necrosis factor-alpha","volume":"14","author":"Ruan","year":"2003","journal-title":"Cytokine Growth Factor Rev."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"S53","DOI":"10.1038\/sj.ijo.0802502","article-title":"Inflammatory pathways and insulin action","volume":"27","author":"Hotamisligil","year":"2003","journal-title":"Int. J. Obes. Relat. Metab. Disord."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"772","DOI":"10.1038\/nri1937","article-title":"Adipocytokines: Mediators linking adipose tissue, inflammation and immunity","volume":"6","author":"Tilg","year":"2006","journal-title":"Nat. Rev. Immunol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"731","DOI":"10.1042\/CS20200895","article-title":"The complex role of adipokines in obesity, inflammation, and autoimmunity","volume":"135","author":"Taylor","year":"2021","journal-title":"Clin. Sci."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1038\/nri2921","article-title":"Adipokines in inflammation and metabolic disease","volume":"11","author":"Ouchi","year":"2011","journal-title":"Nat. Rev. Immunol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1111\/jdi.12144","article-title":"Association between serum adipocytokine levels and microangiopathies in patients with type 2 diabetes mellitus","volume":"5","author":"Jung","year":"2014","journal-title":"J. Diabetes Investig."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Urbaniak, S.K., Boguszewska, K., Szewczuk, M., Ka\u017amierczak-Bara\u0144ska, J., and Karwowski, B.T. (2020). 8-Oxo-7,8-Dihydro-2\u2032-Deoxyguanosine (8-oxodG) and 8-Hydroxy-2\u2032-Deoxyguanosine (8-OHdG) as a Potential Biomarker for Gestational Diabetes Mellitus (GDM) Development. Molecules, 25.","DOI":"10.3390\/molecules25010202"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"25752","DOI":"10.1074\/jbc.270.43.25752","article-title":"The receptor for advanced glycation end products (RAGE) is a cellular binding site for amphoterin. Mediation of neurite outgrowth and co-expression of rage and amphoterin in the developing nervous system","volume":"270","author":"Hori","year":"1995","journal-title":"J. Biol. Chem."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"2327","DOI":"10.1016\/S0021-9258(17)38076-6","article-title":"Glycosylated minor components of human adult hemoglobin. Purification, identification, and partial structural analysis","volume":"253","author":"McDonald","year":"1978","journal-title":"J. Biol. Chem."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1007\/978-3-030-70115-4_14","article-title":"Protein Glycosylation in Diabetes","volume":"1325","author":"Gornik","year":"2021","journal-title":"Adv. Exp. Med. Biol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1177\/1358836X9800300207","article-title":"Diabetes, advanced glycation endproducts and vascular disease","volume":"3","author":"Wautier","year":"1998","journal-title":"Vasc. Med."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"112","DOI":"10.15380\/2277-5706.JCSR.16.01.003","article-title":"Molecular mechanisms underlying diabetic microvascular complications","volume":"5","author":"Bitla","year":"2016","journal-title":"J. Clin. Sci. Res."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1096\/fasebj.13.1.23","article-title":"Contributions of polyol pathway to oxidative stress in diabetic cataract","volume":"13","author":"Lee","year":"1999","journal-title":"FASEB J."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"779S","DOI":"10.1093\/ajcn\/58.5.779S","article-title":"Protein fructosylation: Fructose and the Maillard reaction","volume":"58","author":"Dills","year":"1993","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"3140","DOI":"10.1021\/jf305451p","article-title":"Carbonylation of myofibrillar proteins through the maillard pathway: Effect of reducing sugars and reaction temperature","volume":"61","author":"Villaverde","year":"2013","journal-title":"J. Agric. Food Chem."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"338","DOI":"10.1002\/iub.1375","article-title":"Fructosylation generates neo-epitopes on human serum albumin","volume":"67","author":"Allarakha","year":"2015","journal-title":"IUBMB Life"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1038\/s41392-023-01400-z","article-title":"Diabetic vascular diseases: Molecular mechanisms and therapeutic strategies","volume":"8","author":"Li","year":"2023","journal-title":"Signal Transduct. Target. Ther."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1256","DOI":"10.1161\/01.ATV.16.10.1256","article-title":"Role of NO in flow-induced remodeling of the rabbit common carotid artery","volume":"16","author":"Tronc","year":"1996","journal-title":"Arterioscler. Thromb. Vasc. Biol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1508","DOI":"10.1016\/S1357-2725(02)00075-4","article-title":"Cells in focus: Endothelial cell","volume":"34","author":"Sumpio","year":"2002","journal-title":"Int. J. Biochem. Cell Biol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1172\/JCI5971","article-title":"Characterization of selective resistance to insulin signaling in the vasculature of obese Zucker (fa\/fa) rats","volume":"104","author":"Jiang","year":"1999","journal-title":"J. Clin. Investig."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"472","DOI":"10.1177\/1479164113500680","article-title":"Cellular and molecular mechanisms of endothelial dysfunction in diabetes","volume":"10","author":"Roberts","year":"2013","journal-title":"Diab. Vasc. Dis. Res."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1152\/physrev.00045.2011","article-title":"Mechanisms of diabetic complications","volume":"93","author":"Forbes","year":"2013","journal-title":"Physiol. Rev."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1038\/ncpendmet0366","article-title":"Mechanisms of Disease: Endothelial dysfunction in insulin resistance and diabetes","volume":"3","author":"King","year":"2007","journal-title":"Nat. Clin. Pr. Endocrinol. Metab."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1152\/physrev.00029.2006","article-title":"Nitric oxide and peroxynitrite in health and disease","volume":"87","author":"Pacher","year":"2007","journal-title":"Physiol. Rev."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1585","DOI":"10.1161\/CIRCULATIONAHA.107.716498","article-title":"Reactive nitrogen species induced by hyperglycemia suppresses Akt signaling and triggers apoptosis by upregulating phosphatase PTEN (phosphatase and tensin homologue deleted on chromosome 10) in an LKB1-dependent manner","volume":"116","author":"Song","year":"2007","journal-title":"Circulation"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"1341","DOI":"10.1172\/JCI11235","article-title":"Hyperglycemia inhibits endothelial nitric oxide synthase activity by posttranslational modification at the Akt site","volume":"108","author":"Du","year":"2001","journal-title":"J. Clin. Investig."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"444","DOI":"10.1161\/CIRCULATIONAHA.110.014506","article-title":"Altered mitochondrial dynamics contributes to endothelial dysfunction in diabetes mellitus","volume":"124","author":"Shenouda","year":"2011","journal-title":"Circulation"},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Gupta, A. (2022). Chapter 6\u2014Direct and indirect actions of insulin: Role of insulin receptor, glucose transporters (GLUTs), and sodium-glucose linked transporters (SGLTs). Understanding Insulin and Insulin Resistance, Elsevier.","DOI":"10.1016\/B978-0-12-820234-0.00003-2"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1146\/annurev-pathol-011110-130138","article-title":"Alternative macrophage activation and metabolism","volume":"6","author":"Odegaard","year":"2011","journal-title":"Annu. Rev. Pathol."},{"key":"ref_49","first-page":"442","article-title":"Type 2 Diabetes and its Impact on the Immune System","volume":"16","author":"Berbudi","year":"2020","journal-title":"Curr. Diabetes Rev."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"649","DOI":"10.1016\/j.micinf.2016.05.007","article-title":"Defects in early cell recruitment contribute to the increased susceptibility to respiratory Klebsiella pneumoniae infection in diabetic mice","volume":"18","author":"Martinez","year":"2016","journal-title":"Microbes Infect."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"7633","DOI":"10.1038\/s41598-017-07230-8","article-title":"Analysis of inflammatory cytokine and TLR expression levels in Type 2 Diabetes with complications","volume":"7","author":"Gupta","year":"2017","journal-title":"Sci. Rep."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"622","DOI":"10.1111\/j.1476-5381.2011.01369.x","article-title":"Resistin: Functional roles and therapeutic considerations for cardiovascular disease","volume":"165","author":"Jamaluddin","year":"2012","journal-title":"Br. J. Pharmacol."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1016\/j.bbrc.2003.12.104","article-title":"Direct reciprocal effects of resistin and adiponectin on vascular endothelial cells: A new insight into adipocytokine-endothelial cell interactions","volume":"314","author":"Kawanami","year":"2004","journal-title":"Biochem. Biophys. Res. Commun."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1007\/s00592-005-0187-x","article-title":"Increased serum resistin levels in patients with type 2 diabetes are not linked with markers of insulin resistance and adiposity","volume":"42","author":"Hasegawa","year":"2005","journal-title":"Acta Diabetol."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"1249","DOI":"10.1253\/circj.72.1249","article-title":"Plasma resistin associated with myocardium injury in patients with acute coronary syndrome","volume":"72","author":"Chu","year":"2008","journal-title":"Circ. J."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"642","DOI":"10.1007\/s00134-002-1628-4","article-title":"High glucose impairs superoxide production from isolated blood neutrophils","volume":"29","author":"Perner","year":"2003","journal-title":"Intensive Care Med."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1182\/blood-2007-11-121723","article-title":"Hyperglycemia enhances coagulation and reduces neutrophil degranulation, whereas hyperinsulinemia inhibits fibrinolysis during human endotoxemia","volume":"112","author":"Stegenga","year":"2008","journal-title":"Blood"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"2241","DOI":"10.1016\/j.febslet.2013.05.053","article-title":"High glucose modulates IL-6 mediated immune homeostasis through impeding neutrophil extracellular trap formation","volume":"587","author":"Joshi","year":"2013","journal-title":"FEBS Lett."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"604","DOI":"10.1002\/cbf.2840","article-title":"Neutrophil dysfunction induced by hyperglycemia: Modulation of myeloperoxidase activity","volume":"30","author":"Pennacchi","year":"2012","journal-title":"Cell Biochem. Funct."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"678","DOI":"10.1038\/nri2156","article-title":"Getting to the site of inflammation: The leukocyte adhesion cascade updated","volume":"7","author":"Ley","year":"2007","journal-title":"Nat. Rev. Immunol."},{"key":"ref_61","doi-asserted-by":"crossref","unstructured":"Restrepo, B.I., Twahirwa, M., Rahbar, M.H., and Schlesinger, L.S. (2014). Phagocytosis via complement or Fc-gamma receptors is compromised in monocytes from type 2 diabetes patients with chronic hyperglycemia. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0092977"},{"key":"ref_62","doi-asserted-by":"crossref","unstructured":"Pavlou, S., Lindsay, J., Ingram, R., Xu, H., and Chen, M. (2018). Sustained high glucose exposure sensitizes macrophage responses to cytokine stimuli but reduces their phagocytic activity. BMC Immunol., 19.","DOI":"10.1186\/s12865-018-0261-0"},{"key":"ref_63","doi-asserted-by":"crossref","unstructured":"Berrou, J., Fougeray, S., Venot, M., Chardiny, V., Gautier, J.F., Dulphy, N., Toubert, A., and Peraldi, M.N. (2013). Natural killer cell function, an important target for infection and tumor protection, is impaired in type 2 diabetes. PLoS ONE, 8.","DOI":"10.1371\/journal.pone.0062418"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"1975","DOI":"10.1016\/S0140-6736(14)61601-9","article-title":"Worldwide access to treatment for end-stage kidney disease: A systematic review","volume":"385","author":"Liyanage","year":"2015","journal-title":"Lancet"},{"key":"ref_65","doi-asserted-by":"crossref","unstructured":"Wang, Y., and Gao, L. (2022). Inflammation and Cardiovascular Disease Associated With Hemodialysis for End-Stage Renal Disease. Front. Pharmacol., 13.","DOI":"10.3389\/fphar.2022.800950"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"621","DOI":"10.1093\/ndt\/gfm636","article-title":"Clinical policies on the management of chronic kidney disease patients in Italy","volume":"23","author":"Locatelli","year":"2008","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"S274","DOI":"10.1681\/ASN.2006080926","article-title":"Inflammatory syndrome in patients on hemodialysis","volume":"17","year":"2006","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"244","DOI":"10.1111\/j.1749-6632.2000.tb06651.x","article-title":"Inflamm-aging. An. evolutionary perspective on immunosenescence","volume":"908","author":"Franceschi","year":"2000","journal-title":"Ann. N. Y. Acad. Sci."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"436","DOI":"10.1016\/j.tcb.2018.02.001","article-title":"Hallmarks of Cellular Senescence","volume":"28","author":"Nehme","year":"2018","journal-title":"Trends Cell Biol."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1016\/j.arr.2018.02.001","article-title":"Cellular senescence: Immunosurveillance and future immunotherapy","volume":"43","author":"Burton","year":"2018","journal-title":"Ageing Res. Rev."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1111\/j.1474-9728.2004.00102.x","article-title":"Innate immunity in aging: Impact on macrophage function","volume":"3","author":"Plowden","year":"2004","journal-title":"Aging Cell"},{"key":"ref_72","doi-asserted-by":"crossref","unstructured":"Ducloux, D., Legendre, M., Bamoulid, J., Saas, P., Courivaud, C., and Crepin, T. (2021). End-Stage Renal Disease-Related Accelerated Immune Senescence: Is Rejuvenation of the Immune System a Therapeutic Goal?. Front. Med. (Lausanne), 8.","DOI":"10.3389\/fmed.2021.720402"},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"1856","DOI":"10.1016\/j.ekir.2020.08.031","article-title":"Dialysis-Induced Cardiovascular and Multiorgan Morbidity","volume":"5","author":"Canaud","year":"2020","journal-title":"Kidney Int. Rep."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"60","DOI":"10.4103\/jrms.JRMS_1115_17","article-title":"The complex effects of adipokines in the patients with kidney disease","volume":"23","author":"Vahdat","year":"2018","journal-title":"J. Res. Med. Sci."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"770","DOI":"10.1111\/aor.13887","article-title":"Complement activation by dialysis membranes and its association with secondary membrane formation and surface charge","volume":"45","author":"Melchior","year":"2021","journal-title":"Artif. Organs"},{"key":"ref_76","first-page":"275","article-title":"The activation of complement system in different types of renal replacement therapy","volume":"71","author":"Stepniewska","year":"2020","journal-title":"J. Physiol. Pharmacol."},{"key":"ref_77","doi-asserted-by":"crossref","unstructured":"Poppelaars, F., Faria, B., Gaya da Costa, M., Franssen, C.F.M., van Son, W.J., Berger, S.P., Daha, M.R., and Seelen, M.A. (2018). The Complement. System in Dialysis: A Forgotten Story?. Front. Immunol., 9.","DOI":"10.3389\/fimmu.2018.00071"},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1016\/j.kint.2020.10.026","article-title":"Executive summary of the KDIGO 2021 Clinical Practice Guideline for the Management of Blood Pressure in Chronic Kidney Disease","volume":"99","author":"Cheung","year":"2021","journal-title":"Kidney Int."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1111\/hdi.12948","article-title":"Hemodialysis leads to plasma depletion of lectin complement pathway initiator molecule ficolin-2","volume":"25","author":"Nielsen","year":"2021","journal-title":"Hemodial. Int."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"829","DOI":"10.1002\/prca.201000031","article-title":"Proteomic profiling of blood-dialyzer interactome reveals involvement of lectin complement pathway in hemodialysis-induced inflammatory response","volume":"4","author":"Mares","year":"2010","journal-title":"Proteom. Clin. Appl."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"17335","DOI":"10.1038\/s41598-021-96974-5","article-title":"Comparative analysis of therapeutic effects between medium cut-off and high flux dialyzers using metabolomics and proteomics: Exploratory, prospective study in hemodialysis","volume":"11","author":"Kim","year":"2021","journal-title":"Sci. Rep."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1093\/ckj\/sfu127","article-title":"Low concentrations of citrate reduce complement and granulocyte activation in vitro in human blood","volume":"8","author":"Huang","year":"2015","journal-title":"Clin. Kidney J."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"631","DOI":"10.1182\/blood-2010-01-264051","article-title":"Complement anaphylatoxin C5a contributes to hemodialysis-associated thrombosis","volume":"116","author":"Kourtzelis","year":"2010","journal-title":"Blood"},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"21747","DOI":"10.1038\/s41598-020-78742-z","article-title":"Enhanced neutrophil apoptosis accompanying myeloperoxidase release during hemodialysis","volume":"10","author":"Fukushi","year":"2020","journal-title":"Sci. Rep."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"692","DOI":"10.1016\/j.xkme.2020.06.014","article-title":"Neutrophil Activation and Neutrophil Extracellular Trap Formation in Dialysis Patients","volume":"2","author":"Bieber","year":"2020","journal-title":"Kidney Med."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"E246","DOI":"10.1111\/aor.13268","article-title":"Biocompatibility of Polysulfone Hemodialysis Membranes and Its Mechanisms: Involvement of Fibrinogen and Its Integrin Receptors in Activation of Platelets and Neutrophils","volume":"42","author":"Koga","year":"2018","journal-title":"Artif. Organs"},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"e74","DOI":"10.1182\/blood-2010-02-258558","article-title":"Nomenclature of monocytes and dendritic cells in blood","volume":"116","author":"Ancuta","year":"2010","journal-title":"Blood"},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"F673","DOI":"10.1152\/ajprenal.00013.2016","article-title":"Markers of endothelial damage in patients with chronic kidney disease on hemodialysis","volume":"312","author":"Carmona","year":"2017","journal-title":"Am. J. Physiol. Renal Physiol."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"10236","DOI":"10.1038\/s41598-019-46724-5","article-title":"Contribution of the uremic milieu to an increased pro-inflammatory monocytic phenotype in chronic kidney disease","volume":"9","author":"Schepers","year":"2019","journal-title":"Sci. Rep."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"13964","DOI":"10.1038\/s41598-018-31889-2","article-title":"Hemodialysis-related changes in phenotypical features of monocytes","volume":"8","author":"Liakopoulos","year":"2018","journal-title":"Sci. Rep."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1046\/j.1365-2249.2001.01436.x","article-title":"Haemodialysis monocytopenia: Differential sequestration kinetics of CD14+CD16+ and CD14++ blood monocyte subsets","volume":"123","author":"Nockher","year":"2001","journal-title":"Clin. Exp. Immunol."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"1402","DOI":"10.1093\/ndt\/16.7.1402","article-title":"Strong depletion of CD14(+)CD16(+) monocytes during haemodialysis treatment","volume":"16","author":"Sester","year":"2001","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1111\/1744-9987.12454","article-title":"A Prospective Multicenter Randomized Controlled Study on Interleukin-6 Removal and Induction by a new Hemodialyzer With Improved Biocompatibility in Hemodialysis Patients: A Pilot Study","volume":"20","author":"Kakuta","year":"2016","journal-title":"Ther. Apher. Dial."},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1016\/j.cyto.2019.04.002","article-title":"IL 6 but not TNF is linked to coronary artery calcification in patients with chronic kidney disease","volume":"120","author":"Mucha","year":"2019","journal-title":"Cytokine"},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"958","DOI":"10.1016\/j.kint.2018.12.014","article-title":"Arterial \u201cinflammaging\u201d drives vascular calcification in children on dialysis","volume":"95","author":"Sanchis","year":"2019","journal-title":"Kidney Int."},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"784","DOI":"10.2215\/CJN.11130919","article-title":"Plasma Endothelin-1 and Risk of Death and Hospitalization in Patients Undergoing Maintenance Hemodialysis","volume":"15","author":"Li","year":"2020","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"44","DOI":"10.3164\/jcbn.20-141","article-title":"Hemodialysis raises oxidative stress through carbon-centered radicals despite improved biocompatibility","volume":"69","author":"Hirayama","year":"2021","journal-title":"J. Clin. Biochem. Nutr."},{"key":"ref_98","doi-asserted-by":"crossref","unstructured":"Duni, A., Liakopoulos, V., Roumeliotis, S., Peschos, D., and Dounousi, E. (2019). Oxidative Stress in the Pathogenesis and Evolution of Chronic Kidney Disease: Untangling Ariadne\u2019s Thread. Int. J. Mol. Sci., 20.","DOI":"10.3390\/ijms20153711"},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"2613","DOI":"10.1093\/ndt\/gfm227","article-title":"Neutrophils in acidotic haemodialysed patients have lower intracellular pH and inflamed state","volume":"22","author":"Wann","year":"2007","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1046\/j.1523-1755.61.s80.20.x","article-title":"Oxidative stress in hemodialysis patients: Is. NADPH oxidase complex the culprit?","volume":"61","author":"Morena","year":"2002","journal-title":"Kidney Int. Suppl."},{"key":"ref_101","doi-asserted-by":"crossref","unstructured":"Crespo-Montero, R., G\u00f3mez-L\u00f3pez, V.E., Guerrero-Pav\u00f3n, F., Carmona-Mu\u00f1oz, A., Romero-Salda\u00f1a, M., Ranchal-Sanchez, A., and Aljama-Garc\u00eda, P. (2021). Influence of Tunneled Hemodialysis-Catheters on Inflammation and Mortality in Dialyzed Patients. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18147605"},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1159\/000471814","article-title":"Hemodialysis Patients Display a Declined Proportion of Th2 and Regulatory T Cells in Parallel with a High Interferon-\u03b3 Profile","volume":"136","author":"Mansouri","year":"2017","journal-title":"Nephron"},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1186\/1742-4933-9-19","article-title":"Uremia causes premature ageing of the T cell compartment in end-stage renal disease patients","volume":"9","author":"Meijers","year":"2012","journal-title":"Immun. Ageing"},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1016\/j.clim.2005.09.007","article-title":"Progressive loss of renal function is associated with activation and depletion of naive T lymphocytes","volume":"118","author":"Litjens","year":"2006","journal-title":"Clin. Immunol."},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"624","DOI":"10.1093\/ndt\/gfy276","article-title":"Uraemia-induced immune senescence and clinical outcomes in chronic kidney disease patients","volume":"35","author":"Legendre","year":"2020","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"138","DOI":"10.3109\/0886022X.2011.553300","article-title":"Apoptosis of peripheral CD4(+) T-lymphocytes in end-stage renal disease patients under hemodialysis and rhEPO therapies","volume":"33","author":"Borges","year":"2011","journal-title":"Ren. Fail."},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"5041","DOI":"10.1038\/s41598-019-41619-x","article-title":"The influence of a single hemodialysis procedure on human T lymphocytes","volume":"9","author":"Lisowska","year":"2019","journal-title":"Sci. Rep."},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1007\/s10875-011-9603-x","article-title":"Hemodialysis affects phenotype and proliferation of CD4-positive T lymphocytes","volume":"32","author":"Lisowska","year":"2012","journal-title":"J. Clin. Immunol."},{"key":"ref_109","doi-asserted-by":"crossref","unstructured":"Xiang, F., Cao, X., Chen, X., Zhang, Z., Ding, X., Zou, J., and Shen, B. (2021). Decreased Peripheral Na\u00efve T Cell Number and Its Role in Predicting Cardiovascular and Infection Events in Hemodialysis Patients. Front. Immunol., 12.","DOI":"10.3389\/fimmu.2021.644627"},{"key":"ref_110","doi-asserted-by":"crossref","first-page":"183","DOI":"10.5301\/jn.5000057","article-title":"A killer on the road: Circulating CD4(+)CD28null T cells as cardiovascular risk factor in ESRD patients","volume":"25","author":"Betjes","year":"2012","journal-title":"J. Nephrol."},{"key":"ref_111","doi-asserted-by":"crossref","first-page":"465","DOI":"10.3858\/emm.2012.44.8.053","article-title":"B cell-associated immune profiles in patients with end-stage renal disease (ESRD)","volume":"44","author":"Kim","year":"2012","journal-title":"Exp. Mol. Med."},{"key":"ref_112","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1016\/j.cellimm.2012.06.007","article-title":"Mechanisms underlying sCD40 production in hemodialysis patients","volume":"278","author":"Esposito","year":"2012","journal-title":"Cell. Immunol."},{"key":"ref_113","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1096\/fj.04-2073fje","article-title":"Soluble tumor necrosis factor (TNF) receptor-1 induces apoptosis via reverse TNF signaling and autocrine transforming growth factor-beta1","volume":"19","author":"Waetzig","year":"2005","journal-title":"FASEB J."},{"key":"ref_114","doi-asserted-by":"crossref","first-page":"484","DOI":"10.1016\/j.ejcb.2010.10.007","article-title":"The soluble Interleukin 6 receptor: Generation and role in inflammation and cancer","volume":"90","author":"Chalaris","year":"2011","journal-title":"Eur. J. Cell Biol."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/13\/3687\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T15:03:56Z","timestamp":1760108636000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/13\/3687"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,25]]},"references-count":114,"journal-issue":{"issue":"13","published-online":{"date-parts":[[2024,7]]}},"alternative-id":["jcm13133687"],"URL":"https:\/\/doi.org\/10.3390\/jcm13133687","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,6,25]]}}}