Department of Critical Care Medicine and Respiratory Intensive Care Unit, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
J Microbiol Immunol Infect. 2013 Oct;46(5):338-44. doi: 10.1016/j.jmii.2012.06.012. Epub 2012 Aug 24.
BACKGROUND/PURPOSE(S): We investigated whether CD4(+)CD25(+)Foxp3(+) regulatory T cells (Tregs) are induced in patients suffering from early-stage septic shock and distinguish them from noninfectious patients with systemic inflammatory response.
The study included 37 patients with early-stage septic shock, 15 patients with noninfectious systemic inflammatory response syndrome (SIRS), and 24 heath controls. We prospectively assayed the fraction of Tregs expressing high levels of CD25 and forkhead box P3 (Foxp3) as well as the plasma levels of interferon-γ (IFN-γ), interleukin-4 (IL-4), and soluble CD25 in all the subjects studied.
Compared with the control groups, the plasma levels of IFN-γ [66.10 (45.23-85.08) pg/mL vs. 20.97 (17.58-26.21) pg/mL, p < 0.001] and IL-4 [100.69 (77.41-127.68) pg/mL vs. 70.40 (64.14-80.15) pg/mL, p < 0.001] as well as the IFN-γ/IL-4 ratio [0.66 (0.62-0.67) vs. 0.30 (0.27-0.33), p < 0.001] were significantly elevated in the patients with early-stage septic shock, but there was no difference between patients with sepsis and patients with SIRS. We found that the proportion of CD4(+)CD25(+)Foxp3(+) T cells was significantly increased in the patients with early-stage septic shock [(66.82 ± 21.79%) vs. (51.79 ± 21.79%) vs. (56.45 ± 10.68%), p = 0.003] in comparison with the SIRS and control groups, which could be differentiated from the patients with SIRS. The plasma levels of soluble CD25 were also increased, and positively correlated with the proportion of Tregs in patients with early-stage septic shock (Spearman correlation coefficient = 0.390, p = 0.003).
Our findings indicate that the proportion of CD4(+)CD25(+)Foxp3(+) T cells could be an indicator for the early diagnosis of sepsis. This proportion can also facilitate the evaluation of the patient's immune status and guide suitable immunoregulatory therapy.
背景/目的：我们研究了在早期感染性休克患者中是否会诱导 CD4(+)CD25(+)Foxp3(+)调节性 T 细胞（Tregs），并将其与非感染性全身炎症反应综合征（SIRS）患者区分开来。
本研究纳入了 37 例早期感染性休克患者、15 例非感染性 SIRS 患者和 24 名健康对照者。我们前瞻性检测了所有研究对象中高表达 CD25 和叉头框 P3（Foxp3）的 Tregs 比例以及血浆中干扰素-γ（IFN-γ）、白细胞介素-4（IL-4）和可溶性 CD25 的水平。
与对照组相比，早期感染性休克患者的血浆 IFN-γ [66.10（45.23-85.08）pg/mL 比 20.97（17.58-26.21）pg/mL，p<0.001]和 IL-4 [100.69（77.41-127.68）pg/mL 比 70.40（64.14-80.15）pg/mL，p<0.001]以及 IFN-γ/IL-4 比值 [0.66（0.62-0.67）比 0.30（0.27-0.33），p<0.001]均显著升高，但感染性休克患者与 SIRS 患者之间并无差异。我们发现，早期感染性休克患者中 CD4(+)CD25(+)Foxp3(+)T 细胞的比例明显升高[（66.82±21.79）%比（51.79±21.79）%比（56.45±10.68）%，p=0.003]，与 SIRS 和对照组相比，可以将其与 SIRS 患者区分开来。可溶性 CD25 的血浆水平也升高，并与早期感染性休克患者 Tregs 的比例呈正相关（Spearman 相关系数=0.390，p=0.003）。
我们的研究结果表明，CD4(+)CD25(+)Foxp3(+)T 细胞的比例可能是感染性休克早期诊断的一个指标。该比例还可以帮助评估患者的免疫状态，并指导适当的免疫调节治疗。
