慢性阻塞性肺疾病患者外周血中 Th17 细胞的增加。

Increase of Th17 cells in peripheral blood of patients with chronic obstructive pulmonary disease.

机构信息

COPD and Smoking Cessation Clinics, Instituto Nacional de Enfermedades Respiratorias, Ismael Cosío Villegas, INER, Tlalpan 4502, Mexico 14080, Mexico.

出版信息

Respir Med. 2011 Nov;105(11):1648-54. doi: 10.1016/j.rmed.2011.05.017. Epub 2011 Jul 16.

DOI:10.1016/j.rmed.2011.05.017

PMID:21763119

Abstract

BACKGROUND

Chronic obstructive pulmonary disease (COPD) is a progressive disorder characterized by an inflammatory response to cigarette smoke. A disorder in immune regulation contributing to the pathogenesis of COPD has been suggested, however, little is known about the involvement of CD4 (+) T cells. To determine the distribution of different CD4(+) T cell subsets in patients with COPD, current smokers without COPD (CS) and healthy subjects (HS), and its correlation with pulmonary function.

METHODS

Th1, Th2, Th17 and Treg, subsets, were quantified by flow cytometry in peripheral blood (PB) of 39 patients with COPD, 14 CS and 15 HS. Correlations were assessed with Spearman's rank test. The association between Th17 and lung function was evaluated with a multivariate logistic regression analysis.

RESULTS

An increase of Th17 cells (median 9.7% range 0.8-22.5%) was observed in patients with COPD compared with CS (median 2.8% range 0.8-10.6) and HS (median 0.6% range 0.4-1%, p < 0.0001). Th1 and Tregs subsets were also increased in COPD and CS compared to HS. Inverse correlations were found between Th17 with FEV(1)%p r = -0.57 and with FEV(1)/FVC r = -0.60, (p < 0.0001 for both comparison). In addition, increase of Th17 predicted the presence [OR 1.76 (CI 95% 1.25-2.49, p = 0.001)] and severity of airflow limitation [OR 1.13 (CI95% 1.02-1.25, p = 0.02)].

CONCLUSIONS

The increase of Th17 response and the lost of balance between CD4(+) T cell subsets, suggest a lack of regulation of the systemic inflammatory response that may contribute to pathogenesis in COPD patients.

摘要

背景

慢性阻塞性肺疾病（COPD）是一种以对香烟烟雾的炎症反应为特征的进行性疾病。有人提出，免疫调节紊乱可能与 COPD 的发病机制有关，但对 CD4(+)T 细胞的参与知之甚少。为了确定 COPD 患者、无 COPD 的当前吸烟者（CS）和健康受试者（HS）中不同 CD4(+)T 细胞亚群的分布及其与肺功能的关系。

方法

通过流式细胞术在 39 例 COPD 患者、14 例 CS 和 15 例 HS 的外周血（PB）中定量检测 Th1、Th2、Th17 和 Treg 亚群。采用 Spearman 秩检验评估相关性。采用多元逻辑回归分析评估 Th17 与肺功能的关系。

结果

与 CS（中位数 2.8%，范围 0.8-10.6）和 HS（中位数 0.6%，范围 0.4-1%）相比，COPD 患者中 Th17 细胞（中位数 9.7%，范围 0.8-22.5%）增加。与 HS 相比，COPD 和 CS 中 Th1 和 Treg 亚群也增加。Th17 与 FEV(1)%pr 呈负相关，r = -0.57，与 FEV(1)/FVC r 呈负相关，r = -0.60（p<0.0001 用于两个比较）。此外，Th17 的增加预测了气流受限的存在[比值比 1.76（95%可信区间 1.25-2.49，p = 0.001)]和严重程度[比值比 1.13（95%可信区间 1.02-1.25，p = 0.02）]。