Department of Emergency Medicine and Critical Care, Shanghai East Hospital, Tongji University School of Medicine, No. 150 Jimo Road, Pudong New District, Shanghai, 200120, China.
Shanghai East Hospital, Nanjing Medical University, Nanjing, 211166, China.
BMC Pulm Med. 2022 May 24;22(1):206. doi: 10.1186/s12890-022-01985-1.
The role of B cell subsets remained to be elucidated in a variety of immune diseases, though which was used as an effective biomarker for anti-inflammatory or antiviral response. This study aimed to evaluate the early changes of B cell subtypes distribution in elderly patients with community acquired pneumonia (CAP), as well as the association between B cell subtypes and prognosis.
This prospective study included elderly patients with CAP, severe CAP (sCAP) and healthy elderly subjects between April 2016 and March 2018. Flow cytometry was used to detect CD3, CD20, HLA-DR, CD24, CD27, CD38, IgM, and IgD. CD20 B cells were further divided into naïve B cells (Bn), IgM/D memory B cells (IgM Bm), switched B cells (SwB), and transitional B cells (Btr).
A total of 22 healthy controls, 87 patients with CAP and 58 patients with sCAP were included in the study. Compared to CAP, sCAP was characterized by significantly lower absolute number of B cells, Bn and Btr, significantly lower Btr and Bn subset percentage, while percentage of IgM Bm was significantly higher. Heat map showed Bn and Btr on day 3 and day 7 was negatively correlated with activated partial prothrombin time (APTT), international normalized ratio (INR), sequential organ failure assessment score (SOFA) and Acute Physiology and Chronic Health Evaluation II (APACHE II). After 28-day follow-up, Btr percentage in survival group was significantly higher. Receiver operator characteristic (ROC) curve analysis found that Btr count showed sensitivity of 48.6% and specificity of 87.0% for predicting the 28-day survival, with an area under the ROC curves of 0.689 (p = 0.019).
Severity and prognosis of CAP in elderly people is accompanied by changes in the B cell subsets. Btr subsets could play prognostic role for a short-term mortality of elderly CAP patients.
尽管 B 细胞亚群已被用作抗炎或抗病毒反应的有效生物标志物，但在各种免疫性疾病中，其作用仍有待阐明。本研究旨在评估社区获得性肺炎（CAP）老年患者 B 细胞亚群分布的早期变化，以及 B 细胞亚群与预后之间的关系。
本前瞻性研究纳入了 2016 年 4 月至 2018 年 3 月间的老年 CAP 患者、重症 CAP（sCAP）患者和健康老年人。采用流式细胞术检测 CD3、CD20、HLA-DR、CD24、CD27、CD38、IgM 和 IgD。CD20 B 细胞进一步分为 naïve B 细胞（Bn）、IgM/D 记忆 B 细胞（IgM Bm）、转换 B 细胞（Btr）和过渡 B 细胞（Btr）。
共纳入 22 名健康对照者、87 名 CAP 患者和 58 名 sCAP 患者。与 CAP 相比，sCAP 的 B 细胞、Bn 和 Btr 的绝对值明显较低，Btr 和 Bn 亚群的百分比明显较低，而 IgM Bm 的百分比明显较高。热图显示，第 3 天和第 7 天的 Bn 和 Btr 与活化部分凝血酶原时间（APTT）、国际标准化比值（INR）、序贯器官衰竭评估评分（SOFA）和急性生理学和慢性健康评估 II（APACHE II）呈负相关。28 天随访后，存活组的 Btr 百分比明显升高。受试者工作特征（ROC）曲线分析发现，Btr 计数对预测 28 天存活率的敏感性为 48.6%，特异性为 87.0%，ROC 曲线下面积为 0.689（p=0.019）。
老年人 CAP 的严重程度和预后与 B 细胞亚群的变化有关。Btr 亚群可能对老年 CAP 患者的短期死亡率有预后作用。
