T lymphocytes, monocytes and erythropoiesis disorders in chronic renal failure.

The T lymphocytes, OKT4-depleted T lymphocytes, monocytes, macrophages and the bone marrow early erythroid progenitor (BFU-E) interactions have been evaluated in normal subjects and in uremic patients in predialysis phase (PDP), on hemodialysis (HD) or continuous ambulatory peritoneal dialysis (CAPD). In the same subjects the T-cell growth factor (TCGF) activity and the T-cell subset identification have also been assessed. The results show in uremic patients, particularly in the presence of reduced OKT4 subset and TCGF activity, a blockage of the interactions between immunocompetent and bone marrow cells which normally could stimulate early erythroid progenitor growth. Since this blockage is partially removed by CAPD, this may suggest a more efficient removal of an interaction inhibitor with CAPD than with other dialysis techniques. The mechanism by which such a material may act appears unclear, but it is possible to suppose an inhibiting activity on the production of TCGF by lympho-monocyte cells which under normal conditions could be considered as an early erythropoiesis regulatory factor.