Banegas Marcela, Villafuerte-Gálvez Javier, Paredes Rodrigo, Sprague Rebecca, Barrett Caitlin, Gonzales-Luna Anne J, Daugherty Kaitlyn, Garey Kevin W, Xu Hua, Lin Qianyun, Wang Lamei, Chen Xinhua, Pollock Nira R, Kelly Ciarán P, Alonso Carolyn D
Division of Gastroenterology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
Harvard Medical School, Boston, Massachusetts, USA.
Open Forum Infect Dis. 2023 Feb 18;10(3):ofad090. doi: 10.1093/ofid/ofad090. eCollection 2023 Mar.
infection (CDI) immune response is influenced by the innate and adaptive (humoral) immune systems. Our prior research found attenuated humoral responses to in immunocompromised hosts (ICHs) with CDI. We sought to evaluate whether the innate immune response to CDI was influenced by ICH status.
We conducted a prospective study of hospitalized adults with CDI (acute diarrhea, positive stool nucleic acid amplification testing [NAAT], and decision to treat), with and without immunosuppression and measured a panel of cytokines (granulocyte colony-stimulating factor [G-CSF], interleukin [IL]-10, IL-15, IL-1β, IL-4, IL-6, IL-8, and tumor necrosis factor-α) in blood and stool at CDI diagnosis. Results were compared with measurements from a cohort of asymptomatic carrier patients (ASCs) (NAAT positive, without diarrhea) with and without immunocompromise.
One hundred twenty-three subjects (42 ICHs, 50 non-ICHs, 31 ASCs) were included. Median values for blood and stool cytokines were similar in ICH versus non-ICH CDI subjects. In blood, G-CSF, IL-10, IL-15, IL-6, and IL-8 were higher in both groups of CDI subjects versus the ASC cohort ( < .05). In stool, IL-1β and IL-8 were higher in both groups of CDI subjects versus the ASC cohort ( < .05). Median stool concentrations of IL-1β demonstrated significant differences between the groups (ICHs, 10.97 pg/mL; non-ICHs, 9.71 pg/mL; and ASCs, 0.56 pg/mL) ( < .0001).
In this small exploratory analysis, ICH status did not significantly impact blood and fecal patterns of cytokines in humans at the diagnosis of CDI, suggesting that the innate immune response to may be conserved in immunocompromised patients.
艰难梭菌感染（CDI）的免疫反应受先天性和适应性（体液）免疫系统影响。我们之前的研究发现，免疫功能低下宿主（ICH）发生CDI时，其体液反应减弱。我们试图评估ICH状态是否会影响对CDI的先天性免疫反应。
我们对患有CDI（急性腹泻、粪便核酸扩增检测[NAAT]阳性且决定进行治疗）的住院成人进行了一项前瞻性研究，这些患者有或没有免疫抑制，并在CDI诊断时测量了血液和粪便中的一组细胞因子（粒细胞集落刺激因子[G-CSF]、白细胞介素[IL]-10、IL-15、IL-1β、IL-4、IL-6、IL-8和肿瘤坏死因子-α）。将结果与一组有或没有免疫功能低下的无症状携带者患者（ASC）的测量值进行比较。
纳入了123名受试者（42名ICH、50名非ICH、31名ASC）。ICH与非ICH的CDI受试者血液和粪便细胞因子的中位数相似。在血液中，两组CDI受试者的G-CSF、IL-10、IL-15、IL-6和IL-8均高于ASC队列（P<0.05）。在粪便中，两组CDI受试者的IL-1β和IL-8均高于ASC队列（P<0.05）。各组间IL-1β的粪便中位数浓度存在显著差异（ICH为10.97 pg/mL；非ICH为9.71 pg/mL；ASC为0.56 pg/mL）（P<0.0001）。
在这项小型探索性分析中，ICH状态在CDI诊断时对人体血液和粪便中的细胞因子模式没有显著影响，这表明免疫功能低下患者对艰难梭菌的先天性免疫反应可能是保守的。
