Cao Yaoqian, Chen Jiayue, Dong Lixia
Department of Respiratory and Critical Care Medicine, Tianjin Medical University General Hospital, Tianjin, People's Republic of China.
Infect Drug Resist. 2022 Aug 21;15:4675-4683. doi: 10.2147/IDR.S372427. eCollection 2022.
pneumonia (PCP) has a high mortality in HIV-negative immunocompromised patients. The occurrence and development of PCP are believed to be correlated with the level of lymphocytes and their subsets. The aim of this study was to determine if the levels of lymphocyte subpopulations and immunoglobulin are associated with PCP.
A total of 74 immunocompromised patients were enrolled in this single-center cohort study. Diagnosis of PCP was based on the relevant pulmonary symptoms and radiological imaging, and the detection of in BAL fluid or biopsy tissue by metagenomic next-generation sequencing (mNGS). All patients were divided into two groups (PCP group and non-PCP group) and the patients in PCP group were then divided into two groupsbased on the outcome of the disease during the hospitalization.
We observed a significant lower level of IgG (=0.000) and B lymphocyte counts (=0.017) in the PCP group comparing to that in the non-PCP group. CD4+ T cell counts, as well as the ratio of CD4+/CD8+ T cells in circulation and BAL fluid were also lower in the PCP group comparing to those in the non-PCP group. Lactate dehydrogenase (LDH) in the PCP group was significantly higher than that in the non-PCP group (=0.029). In the PCP group, a lower level of total lymphocytes (=0.004), T cells (=0.001), CD4+ cells (=0.001), and CD8+ cells (=0.007), as well as the proportion of lymphocytes in BAL fluid (=0.000) were found in deceased patients comparing to those in the survived group.
Our study revealed an important role of humoral immunity in the infection of . The level of B cells and IgG could be used as a supplement to predict the occurrence of PCP. The level of CD4+ and CD8+ lymphocytes was significantly correlated with the outcome of PCP.
肺炎（肺孢子菌肺炎，PCP）在HIV阴性免疫功能低下患者中死亡率很高。PCP的发生和发展被认为与淋巴细胞及其亚群水平相关。本研究的目的是确定淋巴细胞亚群水平和免疫球蛋白是否与PCP相关。
本单中心队列研究共纳入74例免疫功能低下患者。PCP的诊断基于相关肺部症状、放射影像学检查以及通过宏基因组下一代测序（mNGS）检测支气管肺泡灌洗（BAL）液或活检组织中的[具体病原体未提及]。所有患者分为两组（PCP组和非PCP组），然后根据住院期间疾病结局将PCP组患者再分为两组。
我们观察到，与非PCP组相比，PCP组的IgG水平（P = 0.000）和B淋巴细胞计数（P = 0.017）显著更低。与非PCP组相比，PCP组循环血和BAL液中的CD4 + T细胞计数以及CD4 + / CD8 + T细胞比值也更低。PCP组的乳酸脱氢酶（LDH）显著高于非PCP组（P = 0.029）。在PCP组中，与存活组患者相比，死亡患者的总淋巴细胞水平（P = 0.004）、T细胞（P = 0.001）、CD4 + 细胞（P = 0.001）和CD8 + 细胞（P = 0.007）以及BAL液中淋巴细胞比例（P = 0.000）更低。
我们的研究揭示了体液免疫在[具体病原体未提及]感染中的重要作用。B细胞和IgG水平可作为预测PCP发生的补充指标。CD4 + 和CD8 + 淋巴细胞水平与PCP结局显著相关。
