Department of Surgery, National Defense Medical College, Saitama, Japan.
Surgery. 2012 Feb;151(2):313-22. doi: 10.1016/j.surg.2011.07.019. Epub 2011 Oct 6.
To investigate the role of CD4+ CD25+ Foxp3+ regulatory T cells (Tregs) in septic conditions, and to examine the potential of targeting them for the treatment of sepsis.
Sepsis-induced immunosuppression has long been considered a factor in late mortality of patients with sepsis. Although Tregs are central to the maintenance of immunologic homeostasis and tolerance, little is known about Treg-mediated immunosuppression in the late stages of sepsis.
Peripheral blood mononuclear cells (MNCs) in septic patients and liver or spleen MNCs collected after a cecal ligation and puncture (CLP) model in C57BL/6 mice were examined to evaluate the roles of Tregs and the correlation of transforming growth factor (TGF)-β or interleukin (IL)-10 with their activity. We next examined the effects of neutralization of TGF-β or IL-10 on the percentages of Tregs in CD4+ T cells and the survival rates of septic mice.
The percentages of Tregs in peripheral blood lymphocytes were significantly increased in patients with sepsis, and there was a significantly positive correlation between serum IL-10 levels and the percentage of Tregs. CLP injury increases the percentages of Tregs in the CD4+ T cells in the spleen, and there was a significantly positive correlation between the percentages of Tregs and the serum IL-10 or TGF-β levels. The neutralization of TGF-β or IL-10 decreased the percentages of Tregs in CD4+ T cells, restored the percentages of CD4+ T cells in spleen MNCs, and improved survival rates in septic mice.
We found an increase in the percentages of Tregs in peripheral blood circulating CD4+ T cells from patients with sepsis, and in splenic MNCs from septic mice, and observed that regulation of Tregs by neutralizing IL-10 or TGF-β might represent a novel strategy for treating the immunosuppressive conditions in sepsis.
探讨 CD4+CD25+Foxp3+调节性 T 细胞(Tregs)在脓毒症中的作用,并研究针对 Tregs 进行治疗的可能性。
脓毒症引起的免疫抑制作用长期以来被认为是导致脓毒症患者后期死亡的一个因素。尽管 Tregs 是维持免疫稳态和耐受的核心,但对于 Tregs 在脓毒症后期介导的免疫抑制作用知之甚少。
检测脓毒症患者外周血单个核细胞(MNC)和 C57BL/6 小鼠盲肠结扎穿孔(CLP)模型后肝脏或脾脏 MNC,以评估 Tregs 的作用,以及转化生长因子(TGF)-β或白细胞介素(IL)-10与其活性的相关性。接下来,我们检测了中和 TGF-β或 IL-10 对 CD4+T 细胞中 Tregs 百分比和脓毒症小鼠存活率的影响。
脓毒症患者外周血淋巴细胞中 Tregs 的百分比显著增加,且血清 IL-10 水平与 Tregs 的百分比呈显著正相关。CLP 损伤增加脾脏 CD4+T 细胞中 Tregs 的百分比,且 Tregs 的百分比与血清 IL-10 或 TGF-β水平呈显著正相关。中和 TGF-β或 IL-10 可降低 CD4+T 细胞中 Tregs 的百分比,恢复脾 MNC 中 CD4+T 细胞的百分比,并提高脓毒症小鼠的存活率。
我们发现脓毒症患者外周血循环 CD4+T 细胞和脓毒症小鼠脾脏 MNC 中 Tregs 的百分比增加,并且通过中和 IL-10 或 TGF-β来调节 Tregs 可能代表治疗脓毒症中免疫抑制状态的一种新策略。