Baltadzhiev Ivan G, Pavlov Pavel I
Department of Infectious Diseases, Faculty of Medicine
Department of Clinical Laboratory, Faculty of Pharmacy, St. George University Hospital, Medical University, Plovdiv, Bulgaria
Folia Med (Plovdiv). 2015 Apr-Jun;57(2):93-103. doi: 10.1515/folmed-2015-0026.
Mediterranean spotted fever (MSF) in Bulgaria is caused by Rickettsia conorii conorii.
This study aims at investigating the absolute counts of T-lymphocyte subsets in the peripheral blood of patients with MSF in order to establish relationships with disease severity.
The absolute counts of T-lymphocyte subsets were tested in the blood of 62 patients in the acute stage of MSF. They were assigned into three age and sex matched groups, based on the severity of disease - with mild, moderate or severe forms. Controls were 32 age and sex matched healthy individuals. The diagnosis was confirmed by an immunofluorescence assay. Immunophenotyping was performed using Epics XL-MCL Coulter, USA flow-cytometer.
The absolute counts of immune competent (CD3+) cells, as well as the counts of helper/inducer (CD3+ CD4+) and suppressor/ cytotoxic (CD3+ CD8+) T-cell subsets decreased in parallel with disease severity. Naïve (CD4+ CD45RA+) and activated memory (CD4+ CD45RO+) T-cell subsets were reduced, particularly in severe MSF. Taken as a whole, the counts of activated (CD3+ HLA-DR+) and that of presenting accessory (CD28+) or stimulatory (CD38+) molecules Т-cell subsets was increased, but in the first two subsets the trend from mild to severe forms of the disease was descending.
Reduced T-lymphocyte subset counts are likely related to trans-migration into perivascular inflammatory foci. The increased number of T-lymphocytes bearing activation molecules reflects a mobilization of the cell-mediated immune response. An important issue of this study is the possible prognostic value of T-cell subsets counting, predicting the evolution of a clinical condition to clinical forms, according to the disease severity.
保加利亚的地中海斑疹热（MSF）由康氏立克次体（Rickettsia conorii conorii）引起。
本研究旨在调查MSF患者外周血中T淋巴细胞亚群的绝对计数，以确定其与疾病严重程度的关系。
对62例处于MSF急性期患者的血液进行T淋巴细胞亚群绝对计数检测。根据疾病严重程度，将他们分为年龄和性别匹配的三组——轻度、中度或重度。对照组为32名年龄和性别匹配的健康个体。通过免疫荧光测定法确诊。使用美国Epics XL-MCL库尔特流式细胞仪进行免疫表型分析。
免疫活性（CD3 +）细胞的绝对计数，以及辅助/诱导（CD3 + CD4 +）和抑制/细胞毒性（CD3 + CD8 +）T细胞亚群的计数随着疾病严重程度的增加而平行下降。初始（CD4 + CD45RA +）和活化记忆（CD4 + CD45RO +）T细胞亚群减少，尤其是在重度MSF中。总体而言，活化（CD3 + HLA-DR +）以及呈递辅助（CD28 +）或刺激（CD38 +）分子的T细胞亚群计数增加，但在前两个亚群中，疾病从轻到重形式的趋势呈下降趋势。
T淋巴细胞亚群计数减少可能与向血管周围炎症病灶的迁移有关。带有活化分子的T淋巴细胞数量增加反映了细胞介导的免疫反应的动员。本研究的一个重要问题是T细胞亚群计数可能具有的预后价值，即根据疾病严重程度预测临床状况向临床形式的演变。
