Sommershof Annette, Aichinger Hannah, Engler Harald, Adenauer Hannah, Catani Claudia, Boneberg Eva-Maria, Elbert Thomas, Groettrup Marcus, Kolassa Iris-Tatjana
Division of Immunology, University of Konstanz, Konstanz, Germany.
Brain Behav Immun. 2009 Nov;23(8):1117-24. doi: 10.1016/j.bbi.2009.07.003. Epub 2009 Jul 18.
Posttraumatic stress disorder (PTSD) is associated with an enhanced susceptibility to various somatic diseases. However, the exact mechanisms linking traumatic stress to subsequent physical health problems have remained unclear. This study investigated peripheral T lymphocyte differentiation subsets in 19 individuals with war and torture related PTSD compared to 27 non-PTSD controls (n=14 trauma-exposed controls; n=13 non-exposed controls). Peripheral T cell subpopulations were classified by their characteristic expression of the lineage markers CD45RA and CCR7 into: naïve (CD45RA(+) CCR7(+)), central memory (T(CM): CD45RA(-) CCR7(+)) and effector memory (T(EM): CD45RA(-) CCR7(-) and T(EMRA): CD45RA(-) CCR7(-)) cells. Furthermore, we analyzed regulatory T cells (CD4(+)CD25(+)FoxP3(+)) and ex vivo proliferation responses of peripheral blood mononuclear cells after stimulation with anti-CD3 monoclonal antibody. Results show that the proportion of naïve CD8(+) T lymphocytes was reduced by 32% (p=0.01), whereas the proportions of CD3(+) central (p=0.02) and effector (p=0.01) memory T lymphocytes were significantly enhanced (+22% and +34%, respectively) in PTSD patients compared to non-PTSD individuals. To a smaller extent, this effect was also observed in trauma-exposed non-PTSD individuals, indicating a cumulative effect of traumatic stress on T cell distribution. Moreover, PTSD patients displayed a 48% reduction in the proportion of regulatory T cells (p<0.001). Functionally, these alterations were accompanied by a significantly enhanced (+34%) ex vivo proliferation of anti-CD3 stimulated T cells (p=0.05). The profoundly altered composition of the peripheral T cell compartment might cause a state of compromised immune responsiveness, which may explain why PTSD patients show an increased susceptibility to infections, and inflammatory and autoimmune diseases.
创伤后应激障碍(PTSD)与对各种躯体疾病的易感性增强有关。然而,将创伤应激与随后的身体健康问题联系起来的确切机制仍不清楚。本研究调查了19名患有与战争和酷刑相关的创伤后应激障碍的个体的外周血T淋巴细胞分化亚群,并与27名非创伤后应激障碍对照者进行比较(n = 14名有创伤暴露史的对照者;n = 13名无创伤暴露史的对照者)。外周血T细胞亚群根据其谱系标志物CD45RA和CCR7的特征性表达分为:初始(CD45RA(+) CCR7(+))、中枢记忆(T(CM):CD45RA(-) CCR7(+))和效应记忆(T(EM):CD45RA(-) CCR7(-)以及T(EMRA):CD45RA(-) CCR7(-))细胞。此外,我们分析了调节性T细胞(CD4(+)CD25(+)FoxP3(+))以及外周血单个核细胞在用抗CD3单克隆抗体刺激后的体外增殖反应。结果显示,与非创伤后应激障碍个体相比,创伤后应激障碍患者初始CD8(+) T淋巴细胞比例降低了32%(p = 0.01),而CD3(+)中枢记忆(p = 0.02)和效应记忆(p = 0.01)T淋巴细胞比例显著升高(分别升高22%和34%)。在较小程度上,这种效应在有创伤暴露史的非创伤后应激障碍个体中也观察到,表明创伤应激对T细胞分布有累积效应。此外,创伤后应激障碍患者的调节性T细胞比例降低了48%(p < 0.001)。在功能上,这些改变伴随着抗CD3刺激的T细胞体外增殖显著增强(+34%)(p = 0.05)。外周血T细胞区室的深刻改变可能导致免疫反应性受损状态,这可能解释了为什么创伤后应激障碍患者对感染、炎症和自身免疫性疾病的易感性增加。