慢性阻塞性肺疾病患者 T 細胞亞群變化及 CD8<sup>+</sup>CD28<sup>+</sup> T 細胞與 C 反應蛋白相關性探討_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

郝月琴 ¹ , 王欣 ² , 李猛 ¹ , 陳建攸 ¹ ,  唐華平 ¹

1. ;
2. ;

Corresponding?author：

唐華平, Email: qdthp@126.com

Keywords：

慢性阻塞性肺疾病; 急性加重; T 細胞亞群; 殺傷性 T 細胞; C 反應蛋白

DOI：

10.7507/1671-6205.201812018

Video：

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目的探討慢性阻塞性肺疾病（簡稱慢阻肺）急性加重期治療前后外周血 T 細胞亞群變化、CD8⁺CD28⁺ T 細胞與 C 反應蛋白（CRP）的相關性及其臨床意義。方法選擇 2015 年 5 月至 2017 年 10 月青島市市立醫院呼吸科慢阻肺急性加重期住院患者 30 例，治療前及治療后 2 周、治療后 3 個月時均空腹抽血 3 mL 進行流式細胞分析 CD3⁺、CD4⁺、CD8⁺、CD4⁺/CD8⁺、CD8⁺CD28⁺ T 細胞，并常規檢測血清 CRP 水平。結果慢阻肺急性加重期患者細胞免疫功能低下，CD4⁺/CD8⁺比值下降，在治療后 CD3⁺、CD4⁺百分比及 CD4⁺/CD8⁺比值均逐漸升高，但治療前與治療后 2 周對比差異無統計學意義，治療前與治療后 3 個月后對比有顯著差異（P<0.05）。治療前與治療后對比 CD8⁺CD28⁺ T 細胞及 CRP 均顯著下降（P<0.05），且二者呈正相關（r=0.86，P<0.05）。結論慢阻肺急性加重患者細胞免疫功能低下紊亂，患者體內 T 細胞亞群失衡的恢復是一個慢性過程。CD8⁺CD28⁺ T 細胞及 CRP 可作為判斷慢阻肺患者病情嚴重程度和預后的指標。

Citation： 郝月琴, 王欣, 李猛, 陳建攸, 唐華平. 慢性阻塞性肺疾病患者 T 細胞亞群變化及 CD8⁺CD28⁺ T 細胞與 C 反應蛋白相關性探討. Chinese Journal of Respiratory and Critical Care Medicine, 2020, 19(1): 75-77. doi: 10.7507/1671-6205.201812018 Copy

1.	Zhang MQ, Wan Y, Jin Y, et al. Cigarette smoking promotes inflammation in patients with COPD by affecting the polarization and survival of Th/Tregs through up-regulation of muscarinic receptor 3 and 5 expression. PLoS One, 2014, 9(11): e112350.
2.	Zhou H, Hua W, Jin Y, et al. Tc17 cells are associated with cigarette smoke-induced lung inflammation and emphysema. Respirology, 2015, 20(3): 426-433.
3.	Podolin PL, Foley JP, Carpenter DC, et al. T cell depletion protects against alveolar destruction due to chronic cigarette smoke exposure in mice. Am J Physiol Lung Cell Mol Physiol, 2013, 304(5): L312-L323.
4.	陳寧, 徐燕, 張永紅, 等. 慢性阻塞性肺病大鼠外周血中 Foxp3⁺調節性 T 細胞及 IL-17、IL-6 水平的變化. 中國現代醫學雜志, 2014, 24(27): 24-28.
5.	Mathai RT, Bhat S. Peripheral blood T-cell populations in COPD, asymptomatic smokers and healthy non-smokers in Indian subpopulation-a pilot study. J Clin Diagn Res, 2013, 7(6): 1109-1113.
6.	李思聰, 卓宋明. T 淋巴細胞免疫在慢性阻塞性肺疾病急性發作中的影響及相關免疫干預進展. 臨床肺科雜志, 2015, 20(10): 1898-1901.
7.	王文娟, 劉淑紅, 姜玉榮, 等. COPD 病患者免疫功能的變化. 臨床肺科雜志, 2012, 17(8): 1511-1512.
8.	Freeman CM, Martinez CH, Todt JC, et al. Acute exacerbations of chronic obstructive pulmonary disease are associated with decreased CD4+ & CD8+ T cells and increased growth & differentiation factor-15 (GDF-15) in peripheral blood. Respir Res, 2015, 16: 94.
9.	Hou J, Sun Y, Hao Y, et al. Imbalance between subpopulations of regulatory T cells in COPD. Thorax, 2013, 68(12): 1131-1139.
10.	Forsslund H, Mikko M, Karimi R, et al. Distribution of T-Cell subsets in BAL fluid of patients with mild to moderate COPD depends on current smoking status and not airway obstruction. Chest, 2014, 145(4): 711-722.
11.	Freeman CM, McCubbrey AL, Crudgington S, et al. Basal gene expression by lung CD4+ T cells in chronic obstructive pulmonary disease identifies independent molecular correlates of airflow obstruction and emphysema extent. PLoS One, 2014, 9(5): e96421.
12.	Chen L, Chen G, Zhang MQ, et al. Imbalance between subsets of CD8+ peripheral blood T cells in patients with chronic obstructive pulmonary disease. Peer J, 2016, 4: e230.
13.	Hodge G, Mukaro V, Reynolds PN, et al. Role of increased CD8/CD28^null T cells and alternative co-stimulatory molecules in chronic obstructive pulmonary disease. Clin Exp Immunol, 2011, 166(1): 94-102.
14.	江雨順, 劉達富. 慢性阻塞性肺疾病患者外周血 T 淋巴細胞亞群和 C 反應蛋白變化的臨床意義. 白求恩醫學雜志, 2016, 14(5): 580-582.

1. Zhang MQ, Wan Y, Jin Y, et al. Cigarette smoking promotes inflammation in patients with COPD by affecting the polarization and survival of Th/Tregs through up-regulation of muscarinic receptor 3 and 5 expression. PLoS One, 2014, 9(11): e112350.
2. Zhou H, Hua W, Jin Y, et al. Tc17 cells are associated with cigarette smoke-induced lung inflammation and emphysema. Respirology, 2015, 20(3): 426-433.
3. Podolin PL, Foley JP, Carpenter DC, et al. T cell depletion protects against alveolar destruction due to chronic cigarette smoke exposure in mice. Am J Physiol Lung Cell Mol Physiol, 2013, 304(5): L312-L323.
4. 陳寧, 徐燕, 張永紅, 等. 慢性阻塞性肺病大鼠外周血中 Foxp3⁺調節性 T 細胞及 IL-17、IL-6 水平的變化. 中國現代醫學雜志, 2014, 24(27): 24-28.
5. Mathai RT, Bhat S. Peripheral blood T-cell populations in COPD, asymptomatic smokers and healthy non-smokers in Indian subpopulation-a pilot study. J Clin Diagn Res, 2013, 7(6): 1109-1113.
6. 李思聰, 卓宋明. T 淋巴細胞免疫在慢性阻塞性肺疾病急性發作中的影響及相關免疫干預進展. 臨床肺科雜志, 2015, 20(10): 1898-1901.
7. 王文娟, 劉淑紅, 姜玉榮, 等. COPD 病患者免疫功能的變化. 臨床肺科雜志, 2012, 17(8): 1511-1512.
8. Freeman CM, Martinez CH, Todt JC, et al. Acute exacerbations of chronic obstructive pulmonary disease are associated with decreased CD4+ & CD8+ T cells and increased growth & differentiation factor-15 (GDF-15) in peripheral blood. Respir Res, 2015, 16: 94.
9. Hou J, Sun Y, Hao Y, et al. Imbalance between subpopulations of regulatory T cells in COPD. Thorax, 2013, 68(12): 1131-1139.
10. Forsslund H, Mikko M, Karimi R, et al. Distribution of T-Cell subsets in BAL fluid of patients with mild to moderate COPD depends on current smoking status and not airway obstruction. Chest, 2014, 145(4): 711-722.
11. Freeman CM, McCubbrey AL, Crudgington S, et al. Basal gene expression by lung CD4+ T cells in chronic obstructive pulmonary disease identifies independent molecular correlates of airflow obstruction and emphysema extent. PLoS One, 2014, 9(5): e96421.
12. Chen L, Chen G, Zhang MQ, et al. Imbalance between subsets of CD8+ peripheral blood T cells in patients with chronic obstructive pulmonary disease. Peer J, 2016, 4: e230.
13. Hodge G, Mukaro V, Reynolds PN, et al. Role of increased CD8/CD28^null T cells and alternative co-stimulatory molecules in chronic obstructive pulmonary disease. Clin Exp Immunol, 2011, 166(1): 94-102.
14. 江雨順, 劉達富. 慢性阻塞性肺疾病患者外周血 T 淋巴細胞亞群和 C 反應蛋白變化的臨床意義. 白求恩醫學雜志, 2016, 14(5): 580-582.

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Chinese Journal of Respiratory and Critical Care Medicine

慢性阻塞性肺疾病患者 T 細胞亞群變化及 CD8⁺CD28⁺ T 細胞與 C 反應蛋白相關性探討

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Chinese Journal of Respiratory and Critical Care Medicine

慢性阻塞性肺疾病患者 T 細胞亞群變化及 CD8+CD28+ T 細胞與 C 反應蛋白相關性探討

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慢性阻塞性肺疾病患者 T 細胞亞群變化及 CD8⁺CD28⁺ T 細胞與 C 反應蛋白相關性探討