Immune system dysregulation in uremia: role of oxidative stress

Abstract

Immune system dysregulation in end-stage renal disease patients is a multifactorial process combining profound immunodeficiency with a state of cellular activation. While at the origin of the deficiency uremic toxins are thought to play a prominent role, the dialysis procedure is the main factor for the genesis of a recurrent cellular activation process leading to a chronic inflammation state dominated by oxidative stress and its related severe complications, e.g. beta(2)-microglobulin amyloid arthropathy and accelerated atherosclerosis. The recent identification of advanced oxidation protein products (AOPPs) in the plasma of uremic patients and the following demonstration that AOPPs act as both potential uremic toxins and proinflammatory mediators, have opened novel areas of research on these novel molecular bases of oxidative stress and on therapeutic strategies aimed at reducing its most deleterious effects in hemodialysis patients.