Roos-Engstrand Ester, Ekstrand-Hammarström Barbro, Pourazar Jamshid, Behndig Annelie F, Bucht Anders, Blomberg Anders
Dept. of Respiratory Medicine and Allergy, University Hospital, Umeå, Sweden.
COPD. 2009 Apr;6(2):112-20. doi: 10.1080/15412550902755358.
The mechanisms behind airway inflammation in chronic obstructive pulmonary disease (COPD) are still not well understood. Here we investigated lymphocyte subtypes in bronchoalveolar lavage fluid, likely to be involved in the pathogenesis of COPD, as well as exploring the effect of smoking cessation. Differential cell counts and T cell subsets were determined in BAL fluid from nineteen individuals with stable COPD (seven smokers, twelve ex-smokers) compared to twelve age-matched never-smokers and thirteen smoking-matched smokers with normal lung function. COPD-patients had higher percentages of airway CD8(+) T cells compared to never-smokers. An increased population of CD4(+) T cells expressed high levels of CD25 in smokers and COPD patients compared to never-smokers, suggesting the presence of regulatory T cells. As the T cell populations in smokers with normal lung function and COPD-patients were similar, the impact of current smoking in COPD was addressed in a subgroup analysis. Activation of CD8(+) T cells was found regardless of smoking habits. In contrast, the enhanced expression of gamma/delta T cells, was mainly associated with current smoking, whilst the increase in T regulatory cells appeared related to both smoking and COPD. Regardless of smoking habits, CD8(+) T cell activation was found in COPD, supporting the contention that this T cell subset may play a role in the pathogenesis of COPD. As CD8(+) T cells coexist with immunoregulatory CD4(+) T cells in airways of COPD patients, it is likely that both cytotoxic T-cell responses and immunosuppressive mechanisms may be of importance in COPD pathogenesis.
慢性阻塞性肺疾病(COPD)气道炎症背后的机制仍未完全明确。在此,我们研究了支气管肺泡灌洗液中可能参与COPD发病机制的淋巴细胞亚型,并探讨了戒烟的影响。对19例稳定期COPD患者(7例吸烟者,12例既往吸烟者)的支气管肺泡灌洗液进行了细胞分类计数和T细胞亚群分析,并与12例年龄匹配的从不吸烟者以及13例肺功能正常且吸烟情况匹配的吸烟者进行了比较。与从不吸烟者相比,COPD患者气道CD8(+) T细胞的百分比更高。与从不吸烟者相比,吸烟者和COPD患者中表达高水平CD25的CD4(+) T细胞数量增加,提示存在调节性T细胞。由于肺功能正常的吸烟者和COPD患者的T细胞群体相似,因此在亚组分析中探讨了当前吸烟对COPD的影响。无论吸烟习惯如何,均发现CD8(+) T细胞被激活。相比之下,γ/δ T细胞的表达增强主要与当前吸烟有关,而调节性T细胞的增加似乎与吸烟和COPD均有关。无论吸烟习惯如何,在COPD患者中均发现了CD8(+) T细胞激活,这支持了该T细胞亚群可能在COPD发病机制中起作用的观点。由于COPD患者气道中CD8(+) T细胞与免疫调节性CD4(+) T细胞共存,细胞毒性T细胞反应和免疫抑制机制可能在COPD发病机制中均起重要作用。