输血相关性急性肺损伤患者调节性T细胞亚群与细胞因子的相关性研究

Study on the correlation between regulatory T cell subsets and cytokines in patients with blood transfusion-related acute lung injury

目的:研究输血相关性急性肺损伤(TRALI)患者调节性T细胞亚群(Treg)与细胞因子的相关性。方法:收集2020年1月—2021年2月收治的TRALI患者43例,选取同期接受输血治疗未出现急性肺损伤患者(非TRALI组)和进行体检健康自愿者(健康组)各40例,采集受试者外周静脉血,采用流式细胞仪测定血液中T淋巴亚群分布及CD4^(+)CD25^(+)Treg细胞因子表达,并进行数据分析。结果:3组CD3^(+)、CD3^(+)CD4^(+)T细胞分布均差异无统计学意义(P>0.05);健康组和非TRALI组外周血CD3^(+)CD8^(+)、CD4^(+)CD25^(+)Treg、CD4^(+)/CD8^(+)的差异无统计学意义(t=0.461、0.240、0.631,P>0.05),与健康组和非TRALI组比较,TRALI组CD3^(+)CD8^(+)、CD4^(+)CD25^(+)Treg细胞占比明显增加(P<0.05),而CD4^(+)/CD8^(+)明显降低(P<0.05);健康组与非TRALI组外周血单个核细胞上清液TGF-β1、IL-10表达水平差异无统计学意义(P>0.05),与健康组与非TRALI组比较,TRALI组TGF-β1、IL-10水平明显升高,差异均有统计学意义(P<0.05);相较于存活组,TRALI死亡患者外周血CD4^(+)CD25^(+)Treg占比及IL-10、TGF-β1表达水平升高,差异均有统计学意义(P<0.05);Pearson相关性分析结果显示,TRALI组患者外周血CD4^(+)CD25^(+)Treg分布与TGF-β、IL-10呈显著正相关(r=0.830、0.159,P<0.05)。结论:TRALI患者外周血CD4^(+)CD25^(+)Treg细胞占比升高,通过上调细胞因子表达而发挥免疫抑制作用,早期监测CD4^(+)CD25^(+)Treg细胞及其细胞因子表达可为TRALI预后评估和临床干预措施提供参考。

Objective:To study the correlation between regulatory T cell subsets(Treg)and cytokines in patients with transfusion-related acute lung injury(TRALI).Methods:We collected 43 TRALI patients who admitted to our hospital from January 2020 to February 2021.At the same time,40 cases of patients with no acute lung injury(non-TRALI group)and healthy volunteers(healthy group)in the physical examination department were selected during the same period.The peripheral venous blood of the subjects was collected and the T lymphocytes in the blood were measured by flow cytometry.Population distribution and CD4^(+)CD25^(+)Treg cytokine expression,and data analysis.Results:There was no significant difference in the distribution of CD3^(+),CD3^(+)CD4^(+)T cells in the 3 groups(P>0.05).There was no significant difference in the peripheral blood CD3^(+)CD8^(+),CD4^(+)CD25^(+)Treg,CD4^(+)/CD8^(+)between the healthy group and the non-TRALI group(t=0.461,0.240,0.631,P>0.05).Compared with healthy group and non-TRALI group,the proportion of CD3^(+)CD8^(+),CD4^(+)CD25^(+)Treg cells in TRALI group increased significantly(P<0.05),while CD4^(+)/CD8^(+)significantly reduced(P<0.05).The expression levels of TGF-β1 and IL-10 in the PBMNC supernatant of the healthy group and the non-TRALI group were not significantly different(P>0.05).Compared with the healthy group and the non-TRALI group,the TGF of the TRALI group-βand IL-10 levels were significantly increased(P<0.05).Compared with the survival group,the proportion of CD4^(+)CD25^(+)Treg in the peripheral blood of patients who died of TRALI and the expression of IL-10 and TGF-β1 significantly increased(P<0.05).Pearson correlation analysis showed that the distribution of CD4^(+)CD25^(+)Treg in the peripheral blood of the TRALI group was significantly positively correlated with TGF-β1 and IL-10(r=0.830,0.159,P<0.05).Conclusion:The proportion of CD4^(+)CD25^(+)Treg cells in the peripheral blood of TRALI patients is increased,which exerts an immunosuppressive effect by up-regulating the expression of cytokines.Early monitoring of CD4^(+)CD25^(+)Treg cells and their cytokine expression can provide reference for prognostic evaluation of TRALI and clinical intervention measures.