慢性肺曲霉病中的先天性和适应性免疫缺陷
Innate and Adaptive Immune Defects in Chronic Pulmonary Aspergillosis.
作者信息
Bongomin Felix, Harris Chris, Foden Philip, Kosmidis Chris, Denning David W
机构信息
Faculty of Biology, Medicine and Health, The University of Manchester, Oxford Rd, Manchester M13 9PL, UK.
The National Aspergillosis Centre, 2nd Floor Education and Research Centre, University Hospital of South Manchester, Southmoor Road, Manchester M23 9LT, UK.
出版信息
J Fungi (Basel). 2017 May 29;3(2):26. doi: 10.3390/jof3020026.
We evaluated the expression of biomarkers of innate and adaptive immune response in correlation with underlying conditions in 144 patients with chronic pulmonary aspergillosis (CPA). Patients with complete medical and radiological records, white cell counts, and a complete panel of CD3, CD4, CD8, CD19, and CD56 lymphocyte subsets were included. Eighty-four (58%) patients had lymphopenia. Six (4%) patients had lymphopenia in all five CD variables. There were 62 (43%) patients with low CD56 and 62 (43%) patients with low CD19. Ten (7%) patients had isolated CD19 lymphopenia, 18 (13%) had isolated CD56 lymphopenia, and 15 (10%) had combined CD19 and CD56 lymphopenia only. Forty-eight (33%) patients had low CD3 and 46 (32%) had low CD8 counts. Twenty-five (17%) patients had low CD4, 15 (10%) of whom had absolute CD4 counts <200/μL. Multivariable logistic regression showed associations between: low CD19 and pulmonary sarcoidosis (Odds Ratio (OR), 5.53; 95% Confidence Interval (CI), 1.43-21.33; = 0.013), and emphysema (OR, 4.58; 95% CI; 1.36-15.38; = 0.014), low CD56 and no bronchiectasis (OR, 0.27; 95% CI, 0.10-0.77; = 0.014), low CD3 and both multicavitary CPA disease (OR, 2.95; 95% CI, 1.30-6.72; = 0.010) and pulmonary sarcoidosis (OR, 4.94; 95% CI, 1.39-17.57; = 0.014). Several subtle immune defects are found in CPA.
我们评估了144例慢性肺曲霉病（CPA）患者先天和适应性免疫反应生物标志物的表达，并将其与潜在疾病相关联。纳入了具有完整医学和放射学记录、白细胞计数以及完整的CD3、CD4、CD8、CD19和CD56淋巴细胞亚群检测结果的患者。84例（58%）患者存在淋巴细胞减少。6例（4%）患者在所有五个CD变量中均存在淋巴细胞减少。有62例（43%）患者CD56水平低，62例（43%）患者CD19水平低。10例（7%）患者存在孤立性CD19淋巴细胞减少，18例（13%）存在孤立性CD56淋巴细胞减少，15例（10%）仅存在CD19和CD56联合淋巴细胞减少。48例（33%）患者CD3水平低，46例（32%）患者CD8计数低。25例（17%）患者CD4水平低，其中15例（10%）的绝对CD4计数<200/μL。多变量逻辑回归显示以下因素之间存在关联：CD19水平低与肺结节病（优势比（OR），5.53；95%置信区间（CI），1.43 - 21.33；P = 0.013）以及肺气肿（OR，4.58；95% CI；1.36 - 15.38；P = 0.014）相关，CD56水平低与无支气管扩张相关（OR，0.27；95% CI，0.10 - 0.77；P = 0.014），CD3水平低与多腔性CPA疾病（OR，2.95；95% CI，1.30 - 6.72；P = 0.010）以及肺结节病（OR，4.94；95% CI，1.39 - 17.57；P = 0.014）均相关。在CPA中发现了几种细微的免疫缺陷。
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