Flögel Luca, Kaiser Elisabeth, Hans Muriel Charlotte, Goedicke-Fritz Sybelle, Bous Michelle, Abdul-Khaliq Hashim, Poryo Martin, Zemlin Michael, Weber Regine
Department of General Pediatrics and Neonatology, Saarland University, Campus Homburg, Homburg, Germany.
Department of Pediatric Cardiology, Saarland University Medical Center, Homburg, Germany.
Front Immunol. 2024 Dec 16;15:1506073. doi: 10.3389/fimmu.2024.1506073. eCollection 2024.
The pleural cavity represents a unique immunological compartment that can mount inflammatory reactions during infections, after surgery and in chronic immunological diseases. The connection between systemic immune reactions in the blood and local immune reactions in pleural effusions remains unclear. This study provides the first comprehensive immunological characterization of paired blood and pleural effusion samples, utilizing combined cell and cytokine analyses in pediatric patients undergoing cardiac surgery.
In 30 pediatric patients (median age: 22 months) with pleural effusion after cardiac surgery for congenital heart defects, corresponding peripheral blood and pleural effusion samples were analyzed for their immune response. We used flow cytometry and multiplex immunoassays to quantify 14 T cell subpopulations and 12 T cell associated cytokines in each biosample.
IL-6, IL-8, IL-10, TNF (p<0.0001) levels were significantly higher in pleural effusion compared to plasma. In contrast, IFN-γ, GM-CSF, IL-17A levels were lower in pleural effusion than in plasma (p ≤ 0.0005). In comparison to peripheral blood, there was a significantly higher proportion of T helper cells 1 (T1, p=0.0023), T helper cells 17 (T17, p=0.0334) and memory effector cytotoxic T cells (CD3CD8CD45ROCD62L, p=0.0449) in pleural effusion and the same trend was observed for memory effector T cells (CD3CD4CD45ROCD62L, p=0.0633) and double-negative T cells (CD3CD4CD8) (p=0.1085). Naïve T cells (CD3CD4CD45ROCD62L) and naïve cytotoxic T cells (CD3CD8CD45ROCD62L) were slightly reduced in pleural effusion compared to peripheral blood (not significant).
Immunological factors in pleural effusions differed significantly from the corresponding blood samples in pediatric patients after cardiac surgery. The results suggest localized production of specific cytokines within the pleural space, while the distribution of other cytokines in pleural effusions appears to be more reflective of the systemic immune response. We found evidence that on the cellular level, the surface marker CD62L may play a key role in navigating T cells between the blood and pleural effusion. This study confirms that the pleural cavity harbors a unique lymphatic compartment, the analysis of which may be useful for both diagnostic and therapeutic purposes.
胸腔代表一个独特的免疫区室，在感染、手术后及慢性免疫疾病期间可引发炎症反应。血液中的全身免疫反应与胸腔积液中的局部免疫反应之间的联系尚不清楚。本研究首次对配对的血液和胸腔积液样本进行了全面的免疫学特征分析，在接受心脏手术的儿科患者中结合细胞和细胞因子分析。
对30例先天性心脏病心脏手术后出现胸腔积液的儿科患者（中位年龄：22个月），分析相应的外周血和胸腔积液样本的免疫反应。我们使用流式细胞术和多重免疫测定法对每个生物样本中的14个T细胞亚群和12种T细胞相关细胞因子进行定量。
胸腔积液中IL-6、IL-8、IL-10、TNF（p<0.0001）水平显著高于血浆。相比之下，胸腔积液中IFN-γ、GM-CSF、IL-17A水平低于血浆（p≤0.0005）。与外周血相比，胸腔积液中辅助性T细胞1（T1，p=0.0023）、辅助性T细胞17（T17，p=0.0334）和记忆效应细胞毒性T细胞（CD3CD8CD45ROCD62L，p=0.0449）的比例显著更高，记忆效应T细胞（CD3CD4CD45ROCD62L，p=0.0633）和双阴性T细胞（CD3CD4CD8）（p=0.1085）也观察到相同趋势。与外周血相比，胸腔积液中初始T细胞（CD3CD4CD45ROCD62L）和初始细胞毒性T细胞（CD3CD8CD45ROCD62L）略有减少（无统计学意义）。
心脏手术后儿科患者胸腔积液中的免疫因子与相应血液样本有显著差异。结果表明胸腔内特定细胞因子的局部产生，而胸腔积液中其他细胞因子的分布似乎更反映全身免疫反应。我们发现有证据表明在细胞水平上，表面标志物CD62L可能在血液和胸腔积液之间的T细胞导航中起关键作用。本研究证实胸腔内存在一个独特的淋巴区室，对其进行分析可能对诊断和治疗都有用。
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