血液透析患者的免疫功能障碍部分是由于自然杀伤细胞(NK细胞)的受损造成的。在癌细胞上表达的NKG2D等激活性受体的配体与NK细胞功能障碍有关，可以导致癌症的发展。本研究对370名开始血液透析的患者进行了调查。测量了血清中可溶性NKG2D配体的水平。癌症史被定义为入组时的任何癌症诊断以及2年随访期间因癌症而住院和死亡。62名有癌症史的患者和308名没有癌症史的患者在透析开始时的生化指标和尿毒状态上基本相似。与MICA最具代表性的NKG2D配体相比，大多数开始透析的患者的血清中检测到了可溶性MICB、ULBP-1和ULBP-2，测得的NKG2D配体（除ULBP-1外）之间存在强相关性。NKG2D配体与肾功能之间的相关性在开始透析的患者中是显著但适度的。癌症史对可溶性NKG2D配体水平没有任何影响。尽管本研究缺乏对照组和连续参数的测量，但对NKG2D配体的表达模式进行了全面描述，并首次阐明了癌症在开始透析的患者中的意义。可溶性NKG2D配体水平升高可能是由于氧化应激的复杂机制，与尿毒环境中的代谢和排泄不足有关，但它们可能掩盖了有癌症史患者血清中可溶性NKG2D配体水平升高的重要性。版权所有 © 2022 Nagai, Tawara, Usui, Ebihara, Ishizu, Kobayashi, Maeda, Kobayashi and Yamagata.

Immune dysfunction in hemodialysis patients is partially due to NK cell impairment. Ligands for NK activating receptors such as NKG2D expressed on cancer cells are involved in NK cell dysfunction and can lead to cancer development.A cohort with 370 patients who started hemodialysis (HD) was investigated. Serum levels of soluble NKG2D ligands were measured. Cancer history was defined as any cancer diagnosis at induction and hospitalization and death due to cancer during 2-year follow-up.Sixty-two patients with and 308 patients without a cancer history showed mostly comparable biochemical parameters and uremic status at HD induction. Soluble MICB, ULBP-1, and ULBP-2 were detected in sera from most patients starting HD rather than MICA, the most representative NKG2D ligand. Measured NKG2D ligands, except for ULBP-1, were strongly correlated with each other. Correlations between NKG2D ligands and renal function were significant but modest in patients starting HD. Cancer history did not have any impact on levels of soluble NKG2D ligands.Even though this investigation lacked a control cohort and serial measurement of parameters, expression patterns of NKG2D ligands were comprehensively described, and the significance of cancer in patients starting HD was elucidated for the first time. Elevated levels of soluble NKG2D ligands occurred potentially due to complex mechanisms of oxidative stress, with insufficient metabolism and excretion in a uremic milieu, but they might mask the significance of elevations in serum levels of soluble NKG2DLs in patients with a cancer history.Copyright © 2022 Nagai, Tawara, Usui, Ebihara, Ishizu, Kobayashi, Maeda, Kobayashi and Yamagata.