Laboratoire d'excellence INFLAMEX, Université de Paris, Inserm, U1152, Paris, France.
APHP, Service de Pneumologie A, Centre de référence des Maladies Pulmonaires Rares, FHU APOLLO, Hôpital Bichat, Paris, France.
Am J Physiol Lung Cell Mol Physiol. 2021 Nov 1;321(5):L847-L858. doi: 10.1152/ajplung.00105.2021. Epub 2021 Sep 8.
Increased blood fibrocytes are associated with a poor prognosis in fibrotic lung diseases. We aimed to determine whether the percentage of circulating fibrocytes could be predictive of severity and prognosis during coronavirus disease 2019 (COVID-19) pneumonia. Blood fibrocytes were quantified by flow cytometry as CD45/CD15/CD34/collagen-1 cells in patients hospitalized for COVID-19 pneumonia. In a subgroup of patients admitted in an intensive care unit (ICU), fibrocytes were quantified in blood and bronchoalveolar lavage (BAL). Serum amyloid P (SAP), transforming growth factor-β1 (TGF-β1), CXCL12, CCL2, and FGF2 concentrations were measured. We included 57 patients in the hospitalized group (median age = 59 yr [23-87]) and 16 individuals as healthy controls. The median percentage of circulating fibrocytes was higher in the patients compared with the controls (3.6% [0.2-9.2] vs. 2.1% [0.9-5.1], = 0.04). Blood fibrocyte count was lower in the six patients who died compared with the survivors (1.6% [0.2-4.4] vs. 3.7% [0.6-9.2], = 0.02). Initial fibrocyte count was higher in patients showing a complete lung computed tomography (CT) resolution at 3 mo. Circulating fibrocyte count was decreased in the ICU group (0.8% [0.1-2.0]), whereas BAL fibrocyte count was 6.7% (2.2-15.4). Serum SAP and TGF-β1 concentrations were increased in hospitalized patients. SAP was also increased in ICU patients. CXCL12 and CCL2 were increased in ICU patients and negatively correlated with circulating fibrocyte count. We conclude that circulating fibrocytes were increased in patients hospitalized for COVID-19 pneumonia, and a lower fibrocyte count was associated with an increased risk of death and a slower resolution of lung CT opacities.
循环纤维细胞增多与纤维化肺部疾病的预后不良有关。我们旨在确定循环纤维细胞的百分比是否可预测 2019 年冠状病毒病（COVID-19）肺炎期间的严重程度和预后。通过流式细胞术将血液纤维细胞定量为 CD45/CD15/CD34/胶原蛋白-1 细胞，用于住院治疗 COVID-19 肺炎的患者。在入住重症监护病房（ICU）的患者亚组中，定量了血液和支气管肺泡灌洗液（BAL）中的纤维细胞。测量了血清淀粉样蛋白 P（SAP）、转化生长因子-β1（TGF-β1）、CXCL12、CCL2 和 FGF2 浓度。我们纳入了 57 名住院患者（中位数年龄=59 岁[23-87]）和 16 名健康对照者。与对照组相比，患者的循环纤维细胞百分比中位数较高（3.6%[0.2-9.2]与 2.1%[0.9-5.1]，=0.04）。与存活者相比，六名死亡患者的血液纤维细胞计数较低（1.6%[0.2-4.4]与 3.7%[0.6-9.2]，=0.02）。在 3 个月时完全 CT 肺部分辨率的患者中，初始纤维细胞计数较高。ICU 组循环纤维细胞计数降低（0.8%[0.1-2.0]），而 BAL 纤维细胞计数为 6.7%（2.2-15.4）。住院患者的血清 SAP 和 TGF-β1 浓度升高。ICU 患者的 SAP 也升高。ICU 患者的 CXCL12 和 CCL2 增加，与循环纤维细胞计数呈负相关。我们得出结论，住院治疗 COVID-19 肺炎的患者循环纤维细胞增多，较低的纤维细胞计数与死亡风险增加和肺部 CT 密度较慢消退相关。
