肥胖对 LVAD 植入后 T 和 NK 细胞的影响。

The Impact of Obesity on T and NK Cells after LVAD Implantation.

机构信息

Heart Center, Department of Cardiac Surgery, HELIOS Clinic, University Hospital Leipzig, Leipzig, Germany.

Fraunhofer Institute for Cell Therapy and Immunology, Leipzig, Germany.

出版信息

Obes Facts. 2023;16(4):364-373. doi: 10.1159/000530174. Epub 2023 May 11.

DOI:10.1159/000530174

PMID:37232004

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10427956/

Abstract

INTRODUCTION

Infections are a major problem after left ventricular assist device (LVAD) implantation that affects morbidity, mortality, and the quality of life. Obesity often increases the risk for infection. In the cohort of LVAD patients, it is unknown if obesity affects the immunological parameters involved in viral defense. Therefore, this study investigated whether overweight or obesity affects immunological parameters such as CD8+ T cells and natural killer (NK) cells.

METHODS

Immune cell subsets of CD8+ T cells and NK cells were compared between normal-weight (BMI 18.5-24.9 kg/m2, n = 17), pre-obese (BMI 25.0-29.9 kg/m2, n = 24), and obese (BMI ≥30 kg/m2, n = 27) patients. Cell subsets and cytokine serum levels were quantified prior to LVAD implantation and at 3, 6, and 12 months after LVAD implantation.

RESULTS

At the end of the first postoperative year, obese patients (31.8% ± 2.1%) had a lower proportion of CD8+ T cells than normal-weight patients (42.4% ± 4.1%; p = 0.04), and the percentage of CD8+ T cells was negatively correlated with BMI (p = 0.03; r = -0.329). The proportion of circulating NK cells increased after LVAD implantation patients in normal-weight (p = 0.01) and obese patients (p < 0.01). Patients with pre-obesity showed a delayed increase (p < 0.01) 12 months after LVAD implantation. Further, obese patients showed an increase in the percentage of CD57+ NK cells after 6 and 12 months (p = 0.01) of treatment, higher proportions of CD56bright NK cells (p = 0.01), and lower proportions of CD56dim/neg NK cells (p = 0.03) 3 months after LVAD implantation than normal-weight patients. The proportion of CD56bright NK cells positively correlated with BMI (p < 0.01, r = 0.403) 1 year after LVAD implantation.

CONCLUSIONS

This study documented that obesity affects CD8+ T cells and subsets of NK cells in patients with LVAD in the first year after LVAD implantation. Lower proportions of CD8+ T cells and CD56dim/neg NK cells and higher proportion of CD56bright NK cells were detected in obese but not in pre-obese and normal-weight LVAD patients during the first year after LVAD implantation. The induced immunological imbalance and phenotypic changes of T and NK cells may influence viral and bacterial immunoreactivity.

摘要

简介

感染是左心室辅助装置（LVAD）植入后的一个主要问题，它会影响发病率、死亡率和生活质量。肥胖通常会增加感染的风险。在 LVAD 患者队列中，尚不清楚肥胖是否会影响参与病毒防御的免疫参数。因此，本研究旨在调查超重或肥胖是否会影响 CD8+T 细胞和自然杀伤（NK）细胞等免疫参数。

方法

比较了正常体重（BMI 18.5-24.9 kg/m2，n=17）、超重（BMI 25.0-29.9 kg/m2，n=24）和肥胖（BMI≥30 kg/m2，n=27）患者的 CD8+T 细胞和 NK 细胞亚群。在 LVAD 植入前和植入后 3、6 和 12 个月时，定量检测细胞亚群和细胞因子血清水平。

结果

在术后第一年结束时，肥胖患者（31.8%±2.1%）的 CD8+T 细胞比例低于正常体重患者（42.4%±4.1%；p=0.04），并且 CD8+T 细胞的百分比与 BMI 呈负相关（p=0.03；r=-0.329）。LVAD 植入后，正常体重（p=0.01）和肥胖（p＜0.01）患者的循环 NK 细胞比例增加。超重患者在 LVAD 植入后 12 个月显示出延迟增加（p＜0.01）。此外，肥胖患者在 6 个月和 12 个月后（p=0.01）治疗后 CD57+NK 细胞的比例增加，CD56bright NK 细胞的比例较高（p=0.01），CD56dim/neg NK 细胞的比例较低（p=0.03）。LVAD 植入后 3 个月，与正常体重患者相比，肥胖患者的 CD56bright NK 细胞比例与 BMI 呈正相关（p＜0.01，r=0.403）。

结论

本研究记录了肥胖影响 LVAD 植入后第一年 LVAD 患者的 CD8+T 细胞和 NK 细胞亚群。在 LVAD 植入后第一年，肥胖而非超重和正常体重的 LVAD 患者中，检测到 CD8+T 细胞和 CD56dim/neg NK 细胞的比例较低，而 CD56bright NK 细胞的比例较高。T 和 NK 细胞的这种诱导性免疫失衡和表型变化可能影响病毒和细菌的免疫反应性。