Research Overview
As of the end of 2020, the number of patients undergoing chronic dialysis therapy due to end-stage renal failure was 347,671. Among the complications associated with dialysis patients, infections account for 21.5% of deaths, making it the second leading cause of mortality. Dialysis patients are prone to immune deficiency due to impaired phagocyte function (such as neutrophils, monocytes, and macrophages) and abnormalities in T and B lymphocytes. Other contributing factors include malnutrition caused by dietary restrictions, anemia, metabolic acidosis, diabetes as an underlying condition, the use of immunosuppressive drugs, compromised skin barriers, and reduced white blood cell and complement function due to the dialysis membrane. These factors increase susceptibility to infections and the likelihood of severe outcomes.
To prevent severe infections, vaccinations that induce active immunity are extremely important. However, the seroconversion rate after influenza vaccination in dialysis patients ranges from 30% to 80%. In the case of the hepatitis B vaccine, while 90-95% of healthy individuals produce antibodies after vaccination, only 50-60% of dialysis patients do, and their antibody levels decline rapidly.
From a clinical perspective, we are studying the immune response to vaccines in dialysis patients to better understand their immune characteristics and explore ways to reduce their susceptibility to infections. This research is being conducted in collaboration with the Department of Microbiology and Immunology at Keio University, the Department of Virus Infection Control at Kitasato University, and the Department of Physiology and Immunology at the University of Zurich.
Currently, we are researching the immune responses to various vaccines, including the COVID-19 vaccine, the influenza vaccine, and the shingles vaccine.
Key Research Achievements
- Mise-Omata S, Ikeda M, Takeshita M, Uwamino Y, Wakui M, Arai T, Yoshifuji A, et al. Memory B Cells and Memory T Cells Induced by SARS-CoV-2 Booster Vaccination or Infection Show Different Dynamics and Responsiveness to the Omicron Variant. J Immunol. 2022 Dec 1;209(11):2104-2113.
- Yoshifuji A, Toda M, Ryuzaki M, et al. T-cell Response and Antibody Production by Booster COVID-19 Vaccination in Japanese Patients with Chronic Kidney Disease Treated with Hemodialysis. Preprints 2022, 2022090101 (doi: 10.20944/preprints202209.0101.v1).
- Yoshifuji A, Toda M, Ryuzaki M, et al. Investigation for the efficacy of COVID-19 vaccine in Japanese CKD patients treated with hemodialysis. Ren Replace Ther. 2022;8(1):39.