细菌性肺炎患者外周血中免疫抑制性细胞亚群分布特性及其临床意义

Distribution characteristics and clinical impact of immunosuppressive subsets in the peripheral blood from patients with bacterial pneumonia

目的 通过检测细菌性肺炎患者外周血中免疫抑制性细胞亚群CD4＋ CD25highTreg、CD8＋ CD28 T的分布特性及分析其与淋巴细胞亚群等分布的相关性,探讨其在肺炎患者的免疫功能中的作用与意义,并为肺炎的临床诊断提供有参考价值的免疫学指标.方法 采用多色荧光标记和流式细胞术检测健康对照（healthycontrol,HC）组（43名）、细菌性肺炎（bacterial pneumonia,BP）组（31例）患者外周血中免疫抑制性细胞亚群CD4＋CD25high/CD4＋ Treg、CD8＋ CD28 T及CD3＋T、CD4＋T、CD8＋T、CD16＋ CD56＋ NK、CD19＋B淋巴细胞亚群和CD14＋单核细胞的分布;采用GraphPad Prism 6.0软件对数据进行分析,计量资料采用单因素方差分析,相关性分析采用Pearson检验,以P＜0.05为差异有统计学意义.结果 患者外周血中免疫抑制性细胞亚群CD4＋ CD25high Treg和CD8＋ CD28 T检测值BP组（分别为7.29±0.6265和19.55±1.917）较HC组（分别为5.28±0.2304和14.44±1.319）均明显上升（t值分别为3.014和2.197,P值均＜0.05）.BP组中CD4＋ CD25high Treg与CD4＋T检测值、CD4＋/CD8＋比值均呈明显正相关性（相关系数r分别为0.3048和0.3547,P值均＜0.05）,与CD8＋T呈负相关（r=-0.3516,P＜0.05）;CD8＋ CD28 T与CD16＋ CD56＋ NK细胞检测值呈正相关（r=0.3476,P＜0.05）.HC组和BP组中CD8＋ CD28-T均与CD4＋T、CD19＋B细胞检测值、CD4/CD8比值呈负相关（HC组r值分别为-0.7698、-0.3208、-0.7403,P值均＜0.05;BP组r值分别为-0.6036、-0.3258、-0.5545,P值均＜0.05）,与CD8＋T检测值呈正相关（HC组r值为0.5899,P＜0.05;肺炎组r值为0.4944,P＜0.05）.结论 CD4＋ CD25highTreg、CD8＋ CD28-T抑制性T细胞亚群在肺炎患者外周血中显著增加,并与部分常规免疫细胞亚群的变化呈明显相关性,因此作为免疫学指标对细菌性肺炎的诊断具有潜在的参考价值.

Objective The current study aims to indicate the impact of immunosuppressive subsets in the peripheral blood from patients with bacterial pneumonia （BP） by investigating the frequencies of immunosuppressive subsets CD4＋ CD25 high Treg and CD8＋ CD28- T in the peripheral blood from with patients BP and further analyzing their correlations with the percentage of lymphocyte subsets, and to provide meaningful immunological indicatrix for clinical diagnosis of pneumonia. Methods The frequencies of immune subsets, including CD4＋ CD25 high Treg, CD8＋CD28-T, CD3＋T, CD4＋T, CD8＋T, CD16＋CD56＋NK and CD19＋B and CD14＋ monoeyte in the peripheral blood from health control （HC） group （43 persons） and BP patients group （31 patients）, were measured by flow cytometry （FCM）. The data were analyzed with GraphPad Prism 6.0 software, one-way ANOVA test applied to the measurement data and Pear.;on test applied to the correlation analysis （P〈0. 05）. Results In the peripheral blood from the pneumonia patients, the T-values （which are 7.29 ±0. 6265 and 19.55±1. 917 respectively） of the immunosuppressive immune subsets, CD4＋ CD25high Treg and CD8＋ CD28- T were significantly increased （t values are 3. 014 and 2. 197 respectively, P 〈0.05）, compared to that of the HC group （which are 5.28 ±0. 2304 and 14. 44 ±1. 319 respectively）. In BP group, the T-values of CD4＋ CD25 high Treg had statistical positive correlation with the T-values of CD4＋T and the ratio of CD4/CD8 （correlation coefficients （r） were 0. 3048 and 0. 3547 respectively, P〈0.05）, and negative correlation with the T-values of CD8＋T （correlation coefficient （r） was -0. 3516, P〈0.05）. The T-values of CD8＋ CD28 population had positive correlation with the T-values of CD16＋ CD56＋ NK （correlation coefficient （r） was 0. 3476, P〈0. 05）. In both HC group and BP group, the T-values of CDS＋ CD28 T population had negative correlation with the T-values of CD4＋ T, CD19＋ B and the ratio of CD4/CD8 （correlation coefficients （r） were -0. 7698, -0. 3208, -0. 7403 in HC group （all P values 〈0.05） and -0. 6036, -0. 3258, -0. 5545 in BP group （all P values 〈0.05）, and positive correlation with the T-values of CD8＋ T （correlation coefficients （r） were 0.5589 in HC group （P〈0.05） and 0.4944 in BP group respectively, P〈0.05）. Conclusion The immunosuppressive subsets CD4＋ CD25 high Treg and CD8＋ CD28- T are significantly increased in the peripheral blood from the pneumonia patients, and they have correlation with change of some regular immune subsets. Thus as immunology parameters, they have potential value in pneumonia＇s diagnosis.