Children's Hospital, Zhejiang University School of Medicine, Hangzhou 310052, China.
Clinical Laboratory, Hangzhou First People's Hospital, Hangzhou 310006, China.
Microbes Infect. 2019 Oct-Nov;21(8-9):386-392. doi: 10.1016/j.micinf.2019.04.002. Epub 2019 Apr 19.
The purpose of this study is to explore the role of different T cell subgroups in the pathogenesis of sepsis in children. Flow cytometry was used to detect the changes in the activation status and the number of T cell subgroups in the peripheral blood of children with sepsis; healthy children were selected as the control group. Compared with healthy children, the number of CD4+ T cells in the peripheral blood of children with sepsis did not change significantly (Z = 1.945, P = 0.052); though the ratio decreased and the median level dropped from 34.6% to 30.7% (Z = 2.257, P = 0.024). However, the number of CD8+ T cells in the blood of children with sepsis increased, and the median level also increased from 0.2 × 10/L to 0.4 × 10/L (Z = -2.404, P = 0.016). In addition, CD3+CD8+HLA-DR + cell level significantly increased, and the median level increased from 4.2% to 24.3% (Z = -5.370, P = 0.000). There was a large heterogeneity in the hospitalization time of sepsis in clinical patients. Compared to patients with a mean hospital stay of 6 days, patients with a median hospital stay of 13 days had a lower CD3+CD4+CD25 + cells percentage, while the percentage of CD3+CD8+HLA-DR+ was higher, resulting in a more apparent increase of CD3+ CD8+HLA-DR+/CD3+CD4+CD25+. Therefore, the failure of CD4+ T cell activation and proliferation, and the excessive activation and proliferation of CD8+ T cells play an important role in the pathogenesis of sepsis. The increase of CD3+CD8+HLA-DR+/CD3+CD4+CD25 + ratio was associated with the extended course of sepsis.
本研究旨在探讨不同 T 细胞亚群在儿童脓毒症发病机制中的作用。采用流式细胞术检测脓毒症患儿外周血 T 细胞亚群活化状态和数量的变化;选择健康儿童作为对照组。与健康儿童相比,脓毒症患儿外周血 CD4+T 细胞数量无明显变化(Z=1.945,P=0.052);但比例下降,中位数水平从 34.6%降至 30.7%(Z=2.257,P=0.024)。然而,脓毒症患儿血液中 CD8+T 细胞数量增加,中位数水平也从 0.2×10/L 增加到 0.4×10/L(Z=-2.404,P=0.016)。此外,CD3+CD8+HLA-DR+细胞水平显著升高,中位数水平从 4.2%升高至 24.3%(Z=-5.370,P=0.000)。临床患者的脓毒症住院时间存在很大的异质性。与平均住院时间为 6 天的患者相比,中位住院时间为 13 天的患者 CD3+CD4+CD25+细胞百分比较低,而 CD3+CD8+HLA-DR+百分比较高,导致 CD3+CD8+HLA-DR+/CD3+CD4+CD25+明显增加。因此,CD4+T 细胞活化和增殖失败,以及 CD8+T 细胞过度活化和增殖,在脓毒症发病机制中发挥重要作用。CD3+CD8+HLA-DR+/CD3+CD4+CD25+比值的增加与脓毒症病程的延长有关。