| [Background]:This study was performed to build region-specific reference ranges of peripheral blood lymphocyte subsets for Chinese healthy adults from the young to the elderly and to evaluate the impact of age on the values. And the healthy references were applied for exploring the characters of lymphocyte subsets in elder patients with solid tumor and opportunistic infection.[Methods]:The healthy subjects were recruited strictly based on the SENIEUR protocol between Feburary 2007 and June 2008 from Peking Union Medical College Hospital (PUMCH). Lymphocyte subsets were examined by three-color flow cytometric analysis. Elder patients with solid tumor and opportunistic infection, who were diagnosed in PUMCH between January 2003 and June 2008 and did the phenotyping test in our lab, were retrospectively analyzed[Results]:(1) Of 151 healthy adults aged 19-86,52 (34.4%) of them were elder individuals (65 years and above,72±5yrs),47 (31.1%) were middle-aged (45-64 years old,54±6yrs), and 52 (34.4%) were young adults (19-44 years old,31±6yrs). Comparisons in parameters among the three cohorts showed that a statistically significant increase in CD16CD56+ NK cell were observed between the middle-aged and elder cohorts, whereas for the majority of the parameters, a significant decline was observed between the young and the middle-aged cohorts. Further results showed that inverse correlations were observed between the age and CD19+ B, CD3+ T, CD3+CD4+ T, CD4+CD45RA+CD62L+naive T cell and CD4+CD28+/CD4+, while positive one was identified between the age and NK cell. Differences between males and females were identified mainly in the percentages of CD8+CD38+/CD8+ and CD8+HLA-DR+/CD8+in young and middle-aged groups, but neither in elder group. The T cell activation makers of CD8+CD38+ and CD8+HLA-DR+ showed reverse trends of association with age.(2) Forty three elder patients (73±7yrs,17of them with lung cancers and 23 of them with digestive cancers) fulfilled the criteria and were analyzed in our study. As compared with healthy control, the absolute counts of lymphocyte, CD19+ B, CD3+ T and CD3+CD4+ T were significantly lower and the percentage of CD8+CD38+/CD8+ was significantly higher. The comparisons of all parameters, except CD4+CD28+/CD4+, between patients with lung cancers and digestive cancers showed no significant differences.(3) Sixteen elder patients (73±7yrs) with fungal infection (pneumocystis jirovecii pneumonia or Invasive aspergillosis) combined with or without tuberculosis or cytomegalovirus infection, who fulfilled our criteria, were analyzed in the study.The comparisons demonstrated that all except the percentages of CD19+ B, CD3+CD4+ T, CD4+CD28+/CD4+ and CD4+/CD8+ were significantly different from the ones of healthy controls.[Conclusions]:We managed to establish reference ranges for three different age groups of Chinese healthy adults. Significant changes of immune parameters provided evidences for immunosenescence and the converse trends of T cell activation markers may provide a clue for further researches on the mechanisms underlining the paradoxical clinical presentation of the elder patients. Retrospective studies showed that obvious immunocompromised situations were observed in elder patients with solid tumor and opportunistic infection. |
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