Nowak Ewelina, Sulicka-Grodzicka Joanna, Strach Magdalena, Bukowska-Strakova Karolina, Siedlar Maciej, Korkosz Ariusz, Grodzicki Tomasz
Department of Internal Medicine and Gerontology, Jagiellonian University Medical College, Kraków, Poland.
Department of Rheumatology, Jagiellonian University Medical College, Kraków, Poland.
Folia Med Cracov. 2020 Nov 30;60(3):5-16. doi: 10.24425/fmc.2020.135791.
Common variable immunodeficiency (CVID) is a primary immunodeficiency disorder related to recurrent infections, as well as a range of non-infectious manifestations including autoimmune and inflammatory disorders. We hypothesized that patients with CVID and different clinical phenotypes would demonstrate alterations in lymphocyte T subsets, including T lymphocytes expressing programmed cell death protein 1 (PD-1), and regulatory T lymphocytes. We performed flow cytometry in two CVID groups: group 1 with infections only, and group 2 with infections and concomitant noninfectious manifestations. Patients were 18-59 years old (mean 35.8 years of age). Increased proportions of CD8+PD-1+ T cells and reduced regulatory T cells were associated with lymphadenopathy. Amount of regulatory T cells correlated with CD8+PD-1+ T lymphocytes (r = 0.54; p = 0.013), and with CRP (r = -0.64; p = 0.004). Forty percent of patients expressed manifestations in addition to infections (group 2), and they had reduction in number of regulatory T cells [8 (3-12) vs. 24 (11-26)/μl; p = 0.034), naive CD4+ T lymphocytes [36 (27-106) vs. 149 (81-283)/μl; p = 0.034], and elevated C-reactive protein (CRP) [5.33 (3.15-8.82) vs. 1 (1-2.16) mg/l; p = 0.003] in comparison to group 1. In conclusion, the amount of CD8+ T cells expressing PD-1 is associated with lymphadenopathy and number of regulatory T cells in patients with CVID. Patients with CVID and non-infectious complications have increased level of inflammation and alterations in regulatory T cells.
普通可变免疫缺陷（CVID）是一种与反复感染相关的原发性免疫缺陷疾病，以及一系列非感染性表现，包括自身免疫和炎症性疾病。我们假设患有CVID和不同临床表型的患者会表现出淋巴细胞T亚群的改变，包括表达程序性细胞死亡蛋白1（PD-1）的T淋巴细胞和调节性T淋巴细胞。我们对两个CVID组进行了流式细胞术检测：第1组仅患有感染，第2组患有感染并伴有非感染性表现。患者年龄在18至59岁之间（平均年龄35.8岁）。CD8 + PD-1 + T细胞比例增加和调节性T细胞减少与淋巴结病有关。调节性T细胞数量与CD8 + PD-1 + T淋巴细胞相关（r = 0.54；p = 0.013），与C反应蛋白（CRP）相关（r = -0.64；p = 0.004）。40%的患者除感染外还表现出其他症状（第2组），与第1组相比，他们的调节性T细胞数量减少[8（3 - 12）对24（11 - 26）/μl；p = 0.034]，初始CD4 + T淋巴细胞数量减少[36（27 - 106）对149（81 - 283）/μl；p = 0.034]，C反应蛋白（CRP）升高[5.33（3.15 - 8.82）对1（1 - 2.16）mg/l；p = 0.003]。总之，表达PD-1的CD8 + T细胞数量与CVID患者的淋巴结病和调节性T细胞数量有关。患有CVID和非感染性并发症的患者炎症水平升高，调节性T细胞发生改变。
