Objective:To investigate the expression and significance of programmed death receptor 1(PD-1)on T lymphocytes in patients with type 2 diabetic kidney disease(DKD).Methods:80 healthy controls(NC group),80 first diagnosis of type 2 diabetes mellitus patients(T2DM group),and 80 type 2 DKD patients(DKD group)were included in this study.According to urinary albumin creatinine ratio(UACR),the DKD group was divided into two subgroups,moderately elevated group(A2DKD group,UACR:30-300 mg·g-1)and severely elevated group(A3DKD group,UACR:>300 mg·g-1),with 40 cases in each subgroup.The expression rate of PD-1 on T lymphocytes subsets in peripheral blood were compared among the three groups.The correlation of estimated glomerular filtration rate(eGFR),serum creatinine(Scr)and UACR with expression rate of PD-1 on killer T lymphocytes was evaluated,and the expression rate of PD-1 on killer T lymphocytes of DKD patients before and after finerenone treatment were compared.Results:The expression rates of PD-1 in total T lymphocyte subset,helper T cell subset,killer T cell subset,and double negative T cell subset showed significant differences among the three groups(P<0.05).Further analysis of the expression rate of PD-1 in subgroups was found the expression rate of PD-1 in the killer T cell subset in the A3DKD group was significantly higher than that in the A2DKD group and T2DM group(all P<0.05).The expression rate of PD-1 in killer T cells was positively correlated with UACR(r=0.243,95％CI:0.024-0.439)and Scr levels(r=0.507,95％CI:0.323-0.654)(all P<0.05),but negatively correlated with eGFR level(r=-0.263,95％CI:-0.456--0.046,P=0.02).After drug treatment,the expression rate of PD-1 in killer T cell subsets of DKD patients was significantly decreased(P<0.05).Conclusion:Increased expression of PD-1 in peripheral blood killer T cell subsets can lead to the progression of DKD,the rate of PD-1 expression in killer T cell subsets can be used as a biological indicator to evaluate the disease.
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