慢性阻塞性肺疾病急性加重期的免疫表型：一项横断面研究。
Immunophenotype in acute exacerbation of chronic obstructive pulmonary disease: a cross-sectional study.
机构信息
Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, NO. 37 Guoxue Alley, Chengdu, Sichuan, 610041, People's Republic of China.
Laboratory of Pulmonary Immunology and Inflammation, Frontiers Science Center for Disease-Related Molecular Network, Sichuan University, Chengdu, People's Republic of China.
出版信息
Respir Res. 2022 May 28;23(1):137. doi: 10.1186/s12931-022-02058-x.
BACKGROUND
Chronic obstructive pulmonary disease (COPD) is a heterogeneous disease, and the immune inflammatory response is thought to play an important role in pathogenesis. However, the immunophenotype of patients with COPD is unknown. Herein, we evaluated the immunophenotype of patients with acute exacerbation of COPD (AECOPD).
METHODS
A cross-sectional study was conducted in West China Hospital from September 2018 to October 2019. The proportion of CD4 + T lymphocyte subtypes (Th1, Th2, Th17 and Treg) and levels of serum cytokines in the peripheral blood of patients with AECOPD, stable COPD (SCOPD), healthy smokers (HSs)and healthy controls (HCs) were evaluated.
RESULTS
A total of 15 HCs, 19 HSs, 42 patients with SCOPD, and 55 patients with AECOPD were included. Compared to patients with SCOPD, Th1 cells, Th17 cells, Treg cell ratio, Th1/Th2 cell ratio, and the levels of C-reactive protein, interleukin (IL)-6, and IL-10 were significantly increased in patients with AECOPD (P < 0.001), while the proportion of Th2 cells was significantly reduced (P < 0.01). The proportion of Th17 cells was positively correlated with COPD Assessment Test score (r = 0.266, P = 0.009), modified Medical Research Council dyspnea score (r = 0.858, P < 0.0001), and Th1 cell ratio (r = 0.403, P < 0.0001) and negatively correlated with forced vital capacity (r = - 0.367, P = 0.009) and proportion of Th2 cells (r = - 0.655, P < 0.0001).
CONCLUSIONS
The immunophenotype of patients with AECOPD shows abnormal activation of Th1, Th17, and Treg cells. There is a correlation between the proportion of Th17 cells and the severity of COPD; therefore, this may represent a novel index for the evaluation of COPD severity.
TRIAL REGISTRATION
China Clinical Trials Registry, ChiCTR1800018452, registered 19 September 2018, https://www.chictr.org.cn/index.aspx .
背景
慢性阻塞性肺疾病（COPD）是一种异质性疾病，免疫炎症反应被认为在发病机制中起重要作用。然而，COPD 患者的免疫表型尚不清楚。在此，我们评估了急性加重期 COPD（AECOPD）患者的免疫表型。
方法
本研究为 2018 年 9 月至 2019 年 10 月在华西医院进行的横断面研究。评估了 AECOPD、稳定期 COPD（SCOPD）、健康吸烟者（HSs）和健康对照者（HCs）外周血 CD4+T 淋巴细胞亚群（Th1、Th2、Th17 和 Treg）的比例和血清细胞因子水平。
结果
共纳入 15 名 HCs、19 名 HSs、42 名 SCOPD 患者和 55 名 AECOPD 患者。与 SCOPD 患者相比，AECOPD 患者的 Th1 细胞、Th17 细胞、Treg 细胞比例、Th1/Th2 细胞比例以及 C 反应蛋白、白细胞介素（IL）-6 和 IL-10 水平显著升高（P<0.001），而 Th2 细胞比例显著降低（P<0.01）。Th17 细胞比例与 COPD 评估测试评分呈正相关（r=0.266，P=0.009），与改良医学研究委员会呼吸困难评分呈正相关（r=0.858，P<0.0001），与 Th1 细胞比例呈正相关（r=0.403，P<0.0001），与用力肺活量呈负相关（r=-0.367，P=0.009），与 Th2 细胞比例呈负相关（r=-0.655，P<0.0001）。
结论
AECOPD 患者的免疫表型表现出 Th1、Th17 和 Treg 细胞的异常激活。Th17 细胞比例与 COPD 的严重程度相关；因此，这可能是评估 COPD 严重程度的新指标。
试验注册
中国临床试验注册中心，ChiCTR1800018452，于 2018 年 9 月 19 日注册，https://www.chictr.org.cn/index.aspx。
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