METHODS: A cross-sectional study was conducted in West China Hospital from September 2018 to October 2019. The proportion of CD4 + T lymphocyte subtypes (Th1, Th2, Th17 and Treg) and levels of serum cytokines in the peripheral blood of patients with AECOPD, stable COPD (SCOPD), healthy smokers (HSs)and healthy controls (HCs) were evaluated.
RESULTS: A total of 15 HCs, 19 HSs, 42 patients with SCOPD, and 55 patients with AECOPD were included. Compared to patients with SCOPD, Th1 cells, Th17 cells, Treg cell ratio, Th1/Th2 cell ratio, and the levels of C-reactive protein, interleukin (IL)-6, and IL-10 were significantly increased in patients with AECOPD (P < 0.001), while the proportion of Th2 cells was significantly reduced (P < 0.01). The proportion of Th17 cells was positively correlated with COPD Assessment Test score (r = 0.266, P = 0.009), modified Medical Research Council dyspnea score (r = 0.858, P < 0.0001), and Th1 cell ratio (r = 0.403, P < 0.0001) and negatively correlated with forced vital capacity (r = - 0.367, P = 0.009) and proportion of Th2 cells (r = - 0.655, P < 0.0001).
CONCLUSIONS: The immunophenotype of patients with AECOPD shows abnormal activation of Th1, Th17, and Treg cells. There is a correlation between the proportion of Th17 cells and the severity of COPD; therefore, this may represent a novel index for the evaluation of COPD severity.
BACKGROUND: China Clinical Trials Registry, ChiCTR1800018452, registered 19 September 2018, https://www.chictr.org.cn/index.aspx .
方法:于2018年9月至2019年10月在华西医院进行了横断面研究。AECOPD患者外周血中CD4+T淋巴细胞亚型(Th1、Th2、Th17、Treg)比例及血清细胞因子水平,稳定期COPD(SCOPD),对健康吸烟者(HSs)和健康对照者(HCs)进行评价.
结果:总共15个HC,19HS,42例SCOPD患者,纳入55例AECOPD患者。与SCOPD患者相比,Th1细胞,Th17细胞,Treg细胞比例,Th1/Th2细胞比例,和C反应蛋白的水平,IL-6和IL-10在AECOPD患者中显著升高(P<0.001),Th2细胞比例明显降低(P<0.01)。Th17细胞比例与COPD评估测试评分呈正相关(r=0.266,P=0.009),改良医学研究理事会呼吸困难评分(r=0.858,P<0.0001),Th1细胞比例(r=0.403,P<0.0001),与强迫肺活量(r=-0.367,P=0.009)和Th2细胞比例(r=-0.655,P<0.0001)呈负相关。
结论:AECOPD患者的免疫表型表现为Th1、Th17和Treg细胞异常活化。Th17细胞的比例与COPD的严重程度之间存在相关性;因此,这可能是评估COPD严重程度的新指标.
背景:中国临床试验注册中心,ChiCTR1800018452,2018年9月19日注册,https://www.chictr.org.cn/index。aspx.