循环 IgM 记忆 B 细胞耗竭预示 COVID-19 预后不良。

Depletion of circulating IgM memory B cells predicts unfavourable outcome in COVID-19.

机构信息

Department of Internal Medicine, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy.

Anatomic Pathology Unit, Department of Molecular Medicine, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy.

出版信息

Sci Rep. 2020 Nov 30;10(1):20836. doi: 10.1038/s41598-020-77945-8.

Abstract

Impaired immune responses have been hypothesised to be a possible trigger of unfavourable outcomes in coronavirus disease 2019 (COVID-19). We aimed to characterise IgM memory B cells in patients with COVID-19 admitted to an internal medicine ward in Northern Italy. Overall, 66 COVID-19 patients (mean age 74 ± 16.6 years; 29 females) were enrolled. Three patients (4.5%; 1 female) had been splenectomised and were excluded from further analyses. Fifty-five patients (87.3%) had IgM memory B cell depletion, and 18 (28.6%) died during hospitalisation (cumulative incidence rate 9.26/100 person-week; 5.8-14.7 95% CI). All patients who died had IgM memory B cell depletion. A superimposed infection was found in 6 patients (9.5%), all of them having IgM memory B cell depletion (cumulative incidence rate 3.08/100 person-week; 1.3-6.8 95% CI). At bivariable analyses, older age, sex, number of comorbidities, and peripheral blood lymphocyte count < 1500/µl were not correlated with IgM memory B cell depletion. A discrete-to-marked reduction of the B-cell compartment was also noticed in autoptic spleen specimens of two COVID-19 patients. We conclude that IgM memory B cells are commonly depleted in COVID-19 patients and this correlates with increased mortality and superimposed infections.

摘要

免疫反应受损被假设为导致 2019 年冠状病毒病(COVID-19)不良结局的一个可能因素。我们旨在描述意大利北部内科病房收治的 COVID-19 患者的 IgM 记忆 B 细胞。共有 66 名 COVID-19 患者(平均年龄 74±16.6 岁;29 名女性)入组。3 名(4.5%;1 名女性)患者已行脾切除术,被排除在进一步分析之外。55 名患者(87.3%)存在 IgM 记忆 B 细胞耗竭,18 名(28.6%)在住院期间死亡(累积发病率 9.26/100 人-周;5.8-14.7%95%CI)。所有死亡患者均存在 IgM 记忆 B 细胞耗竭。6 名患者(9.5%)发现重叠感染,均存在 IgM 记忆 B 细胞耗竭(累积发病率 3.08/100 人-周;1.3-6.8%95%CI)。在单变量分析中,年龄较大、性别、合并症数量和外周血淋巴细胞计数<1500/µl 与 IgM 记忆 B 细胞耗竭无关。在两名 COVID-19 患者的尸检脾脏标本中也观察到 B 细胞区室的离散到明显减少。我们得出结论,IgM 记忆 B 细胞在 COVID-19 患者中普遍耗竭,这与死亡率增加和重叠感染相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e118/7705651/703814be7dfe/41598_2020_77945_Fig1_HTML.jpg

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索