Department of Emergency Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, 100020, China; Beijing Key Laboratory of Cardiopulmonary Cerebral Resuscitation, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, 100020, China.
Department of Emergency Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, 100020, China.
Resuscitation. 2018 Sep;130:13-20. doi: 10.1016/j.resuscitation.2018.06.023. Epub 2018 Jun 22.
Whether regulatory T cells (Tregs) are involved in immune disorders of out-of-hospital cardiac arrest (OHCA) patients after return of spontaneous circulation (ROSC) is still unknown. We aimed to observe the expression of circulatory Tregs in OHCA patients and investigate programmed cell death-1 (PD-1) and human leucocyte antigen-DR (HLA-DR) on Tregs to evaluate the induction and activity of Tregs.
Sixty-seven consecutive OHCA patients who recovered from spontaneous circulation over 12 h were enrolled. Clinical and 28-day outcome data were collected. Peripheral blood samples collected on days 1 and 3 after ROSC were analysed to evaluate PD-1 and HLA-DR expression on Tregs. Fifty healthy individuals were enrolled as healthy controls.
Compared with those in healthy individuals, circulatory Treg counts significantly decreased without changes of Treg/cluster-of-differentiation (CD)4+ lymphocyte ratios on day 1 after ROSC, and the percentage of PD-1+ Tregs and HLA-DR+ Tregs significantly rose. On day 3, Treg/CD4+ lymphocyte ratios rose with persistently low Treg counts, and the expression of PD-1 and HLA-DR on Tregs was not different from that on day 1. On day 1, both circulatory Treg counts and Treg/CD4+ lymphocyte ratios in non-survivors were lower than those in survivors, and Treg/CD4+ lymphocyte ratios increased in non-survivors on day 3. No significant difference of PD-1 and HLA-DR expression on Tregs was found between survivors and non-survivors on day 1.
After ROSC, despite decreased circulatory Treg counts, a relative increase of Treg percentage and enhanced activity of Tregs are involved in early immune regulation of OHCA patients.
目前尚不清楚调节性 T 细胞（Tregs）是否参与院外心脏骤停（OHCA）患者自主循环恢复（ROSC）后的免疫紊乱。本研究旨在观察 OHCA 患者循环 Tregs 的表达，并检测 Tregs 上的程序性细胞死亡蛋白 1（PD-1）和人类白细胞抗原 DR（HLA-DR），以评估 Tregs 的诱导和活性。
连续纳入 67 例 ROSC 后超过 12 h 的 OHCA 患者。收集临床和 28 天结局数据。在 ROSC 后第 1 天和第 3 天采集外周血样，分析 Tregs 上 PD-1 和 HLA-DR 的表达。纳入 50 名健康个体作为健康对照。
与健康个体相比，ROS 后第 1 天循环 Treg 计数明显下降，而 Treg/CD4+淋巴细胞比值无变化，PD-1+Tregs 和 HLA-DR+Tregs 的比例明显升高。第 3 天，Treg/CD4+淋巴细胞比值升高，Treg 计数持续降低，Tregs 上 PD-1 和 HLA-DR 的表达与第 1 天无差异。第 1 天，非幸存者的循环 Treg 计数和 Treg/CD4+淋巴细胞比值均低于幸存者，而非幸存者的 Treg/CD4+淋巴细胞比值在第 3 天升高。第 1 天，幸存者和非幸存者 Tregs 上 PD-1 和 HLA-DR 的表达无差异。
ROS 后，尽管循环 Treg 计数下降，但 Treg 百分比的相对增加和 Tregs 活性的增强参与了 OHCA 患者的早期免疫调节。
