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Immunmechanismen bei Urämie

Immune mechanisms in uraemia

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Summary

There is both clinical and experimental evidence that cellular and humoral immunity are suppressed in patients with renal insufficiency: observations in organ transplantation and in vitro stimulation of lymphocytes from uraemic patients, investigations of acute and late hypersensitivity reactions, the immune response after active immunization as well as changes of immunoglobulins and lymphatic organs in uraemia are discussed in the paper.

The underlying mechanisms are complex and not yet fully understood. Lymphopenia, atrophy of the thymus gland, toxic serum factors, induction of enhancing mechanisms by certain serum fractions and metabolic defects of lymphocytes—all were shown to be involved or at least considered to be. At present, however, it is impossible to define their rank of importance and the exact place they may occupy in the genesis of this type of “natural immunosuppression”.

Zusammenfassung

Befunde bei Organtransplantationen und bei in vitro stimulation von Lymphocyten urämischer Patienten, Untersuchungen der akuten und verzögerten Immunantwort mit Hilfe von Intracutantests, das Verhalten bei aktiver Immunisierung sowie Veränderungen der Immunglobuline und des lymphatischen Gewebes bei Urämie zeigen eindeutig sowohl im Bereich des cellulären als auch des humoralen Systems eine Immunsuppression durch die Urämie (Niereninsuffizienz).

Die Pathogenese dieser Störung ist komplex: Lymphopenie, Thymusatrophie, toxische Serumfaktoren, Induktion von Enhancing Mechanismen durch bestimmte Serumfraktionen sowie Stoffwechseldefekte der Lymphocyten sind die teils nachgewiesenen, teils vermuteten Teilfaktoren.

Die Wertigkeit dieser einzelnen Faktoren ist aber noch offen.

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Authors and Affiliations

  1. II. Med. Abteilung, Städt. Krankenhaus München-Harlaching, Germany

    H. Dobbelstein

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  1. H. Dobbelstein
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Die eigenen Untersuchungen wurden im Rahmen des SFB 37 durchgeführt.

Übersichtsreferat, gehalten am 4.10.74 auf dem X. Symposion der deutschen Gesellschaft für Nephrologie in Innsbruck.

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Dobbelstein, H. Immunmechanismen bei Urämie. Klin Wochenschr 53, 461–466 (1975). https://doi.org/10.1007/BF01468631

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