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COVID-19 患者接受皮质类固醇治疗后的免疫亚群动力学。

Kinetics of Immune Subsets in COVID-19 Patients Treated with Corticosteroids.

机构信息

1st Department of Critical Care and Pulmonary Medicine, School of Medicine, National and Kapodistrian University of Athens, "Evangelismos" General Hospital, 10676 Athens, Greece.

Intensive Care Unit, "G. Gennimatas" General Hospital, 11527 Athens, Greece.

出版信息

Viruses. 2022 Dec 24;15(1):51. doi: 10.3390/v15010051.

DOI:10.3390/v15010051
PMID:36680091
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9865280/
Abstract

RATIONALE

Changes in anti-SARS-CoV-2 defense immune subsets in patients treated with dexamethasone (DXM) for severe COVID-19 and their relation to disease outcomes are poorly understood.

METHODS

Blood-lymphocyte subsets of 110 hospitalized COVID-19 patients were prospectively examined. A first sample was taken at enrollment and a second one 7-10 days later. Total B-, T-lymphocytes, CD4+, CD8+, T-regulatory (Treg), Natural-Killer (NK) and NK T-cells were counted using flow cytometry.

RESULTS

At enrollment, patients with respiratory failure, characterized by DXM failure (intubation/death) or DXM success (hospital discharge) exhibited significantly fewer CD3+, CD4+ and CD8+ cells and B-lymphocytes compared to the control group (no respiratory failure/no DXM). At the time of treatment completion, the DXM-failure group exhibited significantly fewer CD3+, CD4+ and CD8+ cells, memory CD4+ and CD8+ T-lymphocytes, compared to the control and the DXM-success groups and fewer activated CD4+ T-lymphocytes, Tregs and NK cells compared to the control group. At the time of treatment completion, the number of all investigated lymphocyte subsets increased in the DXM-success group and was similar to those of the control group. NK cells significantly decreased over time in the DXM-failure group.

CONCLUSION

The lymphocyte kinetics differ between DXM-treated and control COVID-19 patients and are associated with clinical outcomes.

摘要

理由

接受地塞米松（DXM）治疗的重症 COVID-19 患者中抗 SARS-CoV-2 防御免疫亚群的变化及其与疾病结局的关系尚不清楚。

方法

前瞻性检查了 110 名住院 COVID-19 患者的血液淋巴细胞亚群。第一次采样在入组时进行，第二次采样在 7-10 天后进行。使用流式细胞术计数总 B 细胞、T 细胞、CD4+、CD8+、T 调节（Treg）、自然杀伤（NK）和 NK T 细胞。

结果

入组时，与对照组（无呼吸衰竭/无 DXM）相比，呼吸衰竭患者（以 DXM 失败为特征，即插管/死亡或 DXM 成功为特征，即出院）的 CD3+、CD4+和 CD8+细胞和 B 淋巴细胞明显减少。在治疗完成时，与对照组和 DXM 成功组相比，DXM 失败组的 CD3+、CD4+和 CD8+细胞、记忆 CD4+和 CD8+T 淋巴细胞明显减少，与对照组相比，激活的 CD4+T 淋巴细胞、Tregs 和 NK 细胞明显减少。在治疗完成时，DXM 成功组所有研究的淋巴细胞亚群数量增加，与对照组相似。NK 细胞在 DXM 失败组中随时间显著减少。

结论

接受 DXM 治疗和未接受 DXM 治疗的 COVID-19 患者的淋巴细胞动力学不同，与临床结局相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b113/9865280/1cd9c7dad657/viruses-15-00051-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b113/9865280/13edbf9b897b/viruses-15-00051-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b113/9865280/8f51eb0367fa/viruses-15-00051-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b113/9865280/49ee61bc3551/viruses-15-00051-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b113/9865280/1cd9c7dad657/viruses-15-00051-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b113/9865280/13edbf9b897b/viruses-15-00051-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b113/9865280/8f51eb0367fa/viruses-15-00051-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b113/9865280/49ee61bc3551/viruses-15-00051-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b113/9865280/1cd9c7dad657/viruses-15-00051-g004.jpg

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