脓毒症患儿存在 T 细胞亚群失衡。
An imbalance of T cell subgroups exists in children with sepsis.
机构信息
Children's Hospital, Zhejiang University School of Medicine, Hangzhou 310052, China.
Clinical Laboratory, Hangzhou First People's Hospital, Hangzhou 310006, China.
出版信息
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。