4th Department of Internal Medicine, University of Athens, Medical School, Athens, Greece.
Clin Exp Immunol. 2010 Sep;161(3):576-83. doi: 10.1111/j.1365-2249.2010.04208.x.
Regulatory T cells (T(regs) ) have an anti-inflammatory role. A former study in a limited number of patients found that absolute counts of T(regs) increase when infection by the new influenza H1N1 virus is complicated with pneumonia. These results generate the question if H1N1-related pneumonia is associated with a state of hypo-inflammation. A total of 135 patients were enrolled with blood sampling within less than 24 h from diagnosis; 23 with flu-like syndrome; 69 with uncomplicated H1N1-infection; seven with bacterial pneumonia; and 36 with H1N1-related pneumonia. T(regs) and CD14/HLA-DR co-expression were estimated by flow cytometry; concentrations of tumour necrosis factor-alpha (TNF-α), of interleukin (IL)-6 and of soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) by an enzyme immunoassay; those of procalcitonin (PCT) by immuno-time-resolved amplified cryptate technology assay. Expression of human leucocyte antigen D-related (HLA-DR) on monocytes was similar between groups; absolute T(reg) counts were greater among patients with H1N1-related pneumonia than flu-like syndrome or H1N1-uncomplicated infection. Serum TNF-α of patients with bacterial pneumonia was greater than those of other groups, but IL-10 was similar between groups. Serum PCT was greater among patients with H1N1-related pneumonia and sTREM-1 among those with H1N1-related pneumonia. Regression analysis revealed that the most important factors related with the advent of pneumonia were the existence of underlying illnesses (P = 0·006) and of T(regs) equal to or above 16 mm(3) (P = 0·013). It is concluded that the advent of H1N1-related pneumonia is related to an early increase of the absolute T(reg) counts. This increase is probably not part of a hypo-inflammatory state of the host.
调节性 T 细胞（Tregs）具有抗炎作用。一项针对少数患者的研究发现，当新型流感 H1N1 病毒感染合并肺炎时，Tregs 的绝对计数会增加。这些结果提出了一个问题，即 H1N1 相关肺炎是否与低炎症状态有关。共纳入 135 例患者，在诊断后 24 小时内进行采血；23 例流感样综合征；69 例单纯 H1N1 感染；7 例细菌性肺炎；36 例 H1N1 相关肺炎。通过流式细胞术估计 Tregs 和 CD14/HLA-DR 共表达；通过酶联免疫吸附试验测定肿瘤坏死因子-α（TNF-α）、白细胞介素（IL）-6 和可溶性髓系细胞触发受体-1（sTREM-1）的浓度；通过免疫时间分辨扩增 cryptate 技术测定降钙素原（PCT）的浓度。单核细胞上人类白细胞抗原 D 相关（HLA-DR）的表达在各组之间相似；H1N1 相关肺炎患者的绝对 Treg 计数高于流感样综合征或 H1N1 单纯感染患者。细菌性肺炎患者的血清 TNF-α高于其他组，但各组之间的 IL-10 相似。H1N1 相关肺炎患者的血清 PCT 较高，而 H1N1 相关肺炎患者的 sTREM-1 较高。回归分析显示，与肺炎发生相关的最重要因素是基础疾病的存在（P = 0.006）和 Tregs 等于或高于 16mm³（P = 0.013）。结论：H1N1 相关肺炎的发生与 Treg 绝对计数的早期增加有关。这种增加可能不是宿主低炎症状态的一部分。
