Department of Internal Medicine, University of Pavia, Pavia, Italy.
Cardiothoracic and Vascular Department, Pneumology Unit, IRCCS Policlinico San Matteo Foundation, Pavia, Italy.
BMC Pulm Med. 2017 Jul 18;17(1):102. doi: 10.1186/s12890-017-0446-y.
The role of CD4CD25CD127 T-reg cells in solid-organ Transplant (Tx) acceptance has been extensively studied. In previous studies on kidney and liver recipients, peripheral T-reg cell counts were associated to graft survival, while in lung Tx, there is limited evidence for similar findings. This study aims to analyze long term peripheral kinetics of T-reg-cells in a cohort of lung recipients and tests its association to several clinical variables.
From jan 2009 to dec 2014, 137 lung Tx recipients were submitted to an immunological follow up (median: 105.9 months (6.7-310.5)). Immunological follow up consisted of a complete blood peripheral immuno-phenotype, inclusive of CD4CD25CD127 T and FOXP3+ cells. We tested the association between T-reg and relevant variables by linear OR regression models for repeated measures, adjusting for time from Tx. Also, by ordered logistic models for panel data, the association between Chronic Lung Allograft Dysfuncton (CLAD) onset/progression and T-reg counts in the previous 3 months was tested.
Among all variables analyzed at multivariate analysis: Bronchiolitis Obliterans Syndrome (OR -6.51, p < 0.001), Restrictive Allograft Syndrome (OR -5.19, p = 0.04) and Extracorporeal photopheresis (OR -5.65, p < 0.001) were significantly associated to T-reg cell. T-reg cell counts progressively decreased according to the severity of CLAD. Furthermore, patients with higher mean T-reg counts in a trimester had a significantly lower risk (OR 0.97, p = 0.012) of presenting CLAD or progressing in the graft dysfunction in the following trimester.
Our present data confirm animal observations on the possible role of T-reg in the evolution of CLAD.
CD4CD25CD127 T 调节细胞在实体器官移植 (Tx) 接受中的作用已得到广泛研究。在先前的肾脏和肝脏受者研究中，外周 T 调节细胞计数与移植物存活率相关，而在肺 Tx 中，类似的发现证据有限。本研究旨在分析一组肺受者的外周 T 调节细胞的长期动力学，并测试其与几个临床变量的相关性。
从 2009 年 1 月至 2014 年 12 月，137 例肺 Tx 受者接受免疫随访（中位数：105.9 个月（6.7-310.5））。免疫随访包括外周免疫表型的全血细胞免疫表型，包括 CD4CD25CD127 T 和 FOXP3+细胞。我们通过线性或重复测量的 OR 回归模型测试 T 调节细胞与相关变量之间的相关性，调整 Tx 后的时间。另外，通过面板数据有序逻辑模型，测试在之前 3 个月内 T 调节细胞计数与慢性肺移植物功能障碍（CLAD）发病/进展的相关性。
在多变量分析中，所有分析的变量中：闭塞性细支气管炎综合征（OR-6.51，p<0.001）、限制性移植综合征（OR-5.19，p=0.04）和体外光化学疗法（OR-5.65，p<0.001）与 T 调节细胞显著相关。T 调节细胞计数随着 CLAD 的严重程度逐渐降低。此外，在一个季度内 T 调节细胞计数较高的患者在下一个季度中出现 CLAD 或移植物功能障碍进展的风险显著降低（OR 0.97，p=0.012）。
我们目前的数据证实了动物观察到的 T 调节细胞在 CLAD 发生发展中的可能作用。
