Expression Of CD4~+CD25~+FoxP3~+T Cells In Patients With Chronic Obstructive Pulmonary Disease And Its Correlation With Clinical Evaluation Indicators

Objective:The purpose of this study was to detect changes in the proportion of CD4⁺CD25⁺FoxP3⁺T cells in peripheral blood of patients with chronic obstructive pulmonary disease?COPD?during acute exacerbation and stable phase and its relationship with clinical evaluation indicators:Lung Function,PaO₂,PaCO₂,BODE index,CAT score,mMRC score,6min walking distance?6MWT?,C-reactive protein?CRP?,fibrinogen?FIB?,interleukin-2?IL-2?,Interleukin-10?IL-10?and Transforming Growth Factor-??TGF-??,to explore the expression of CD4⁺CD25⁺Foxp3⁺T cells in patients with chronic obstructive pulmonary disease and its correlation with clinical evaluation indicators.Methods:A total of 30 patients with Acute exacerbation of chronic obstructive pulmonary disease?AECOPD??26 males and 4 females?and 30 patients with stable COPD?SCOPD?were included in this study?25 males and 5 females?and 30 healthy controls?23males and 7 females?.All subjects collected information such as age,gender,height,weight,CRP,FIB,PaO₂,PaCO₂,etc.,and detected pulmonary function indicators.At the same time,the subjects'body mass index?BMI?,BODE index,CAT score,mMRC score and 6MWT were evaluated.4ml of peripheral blood was collected from the subject,and2ml of blood was used to complete the flow cytometry to detect the proportion of CD4⁺CD25⁺FoxP3⁺T cells in the peripheral blood within 6h.2ml of blood was collected after centrifugation,and stored at-80?in the refrigerator for future use.Immunosorbent assay?ELISA?was used to measure the levels of IL-2,IL-10 and TGF-?in the serum of the subjects.Linear correlation analysis was used to evaluate the correlation between the proportion of CD4⁺CD25⁺FoxP3⁺T cells in peripheral blood of patients with COPD and clinical evaluation indicators.Results:1.Sex ratio,age,BMI of the three groups were of no significant difference?all P>0.05?.2.COPD clinical evaluation indicators test results:The FVC,FEV₁/FVC%,FEV₁%pred,PaO₂,IL-2 and 6MWT in AECOPD group were significantly lower than those in SCOPD group,the differences were statistically significant?all P<0.05?,but there was no significant difference in IL-10?P>0.05?.The FVC,FEV₁/FVC%,FEV₁%pred,PaO₂,IL-2,IL-10 and 6MWT in SCOPD group were significantly lower than those in healthy control group,the differences were statistically significant?all P<0.05?.The CRP,FIB,PaCO₂,BODE index,CAT score,mMRC score and TGF-?in AECOPD group were significantly higher than those of in SCOPD group,the differences were statistically significant?all P<0.05?.The FIB,BODE index,CAT score,mMRC score and TGF-?in SCOPD group were significantly higher than those in healthy control group,the differences were statistically significant?all P<0.05?,but there was no significant difference in CRP?P>0.05?.3.Correlation between the proportion of subject's peripheral blood CD4⁺CD25⁺FoxP3⁺T cells and lung function,PaO₂,PaCO₂:From the overall analysis of COPD patients,it can be seen that the proportion of Treg cells and FVC,FEV₁%pred,FE V₁/FVC%,PaO₂ are all significant positive correlation?all P<0.05?;the proportion of Treg cells was significantly negatively correlated with PaCO₂?P<0.05?.However,no significant correlation was seen between the three subgroups.4.Correlation between the ratio of CD4⁺CD25⁺FoxP3⁺T cells in peripheral blood of subjects and indicators of inflammatory response:From the overall analysis of COPD patients,the proportion of Treg cells was significantly negatively correlated with CRP,FIB and TGF-??all P<0.05?;the proportion of Treg cells was significantly positively correlated with IL-2?P<0.05?;but not significantly correlated with IL-10?P>0.05?.Another subgroup analysis found that in the AECOPD group,the proportion of Treg cells was significantly negatively correlated with CRP and FIB?all P<0.05?;the proportion of Treg cells was significantly positively correlated with IL-2?P<0.05?.In the SCOPD group,the proportion of Treg cells was significantly positively correlated with IL-2 and IL-10?all P<0.05?.In the healthy control group,there was no significant correlation.5.Correlation between peripheral blood CD4⁺CD25⁺FoxP3⁺T cell ratio and COPD clinical score:From the overall analysis of COPD patients,the proportion of Treg cells was significantly negatively correlated with BODE index,CAT score and mMRC score?all P<0.05?;the proportion of Treg cells was significantly positively correlated with 6MWT?P<0.05?.Another subgroup analysis found that there was no significant correlation among the AECOPD group,SCOPD group,and healthy control group?all P>0.05?.6.Correlation between subjects'lung function and inflammatory response indicators:From the overall analysis of COPD patients,FVC,FEV₁%pred,FEV₁/FVC%were significantly negatively correlated with CRP,FIB,TGF-??all P<0.05?;FVC,FEV₁%pred,FEV₁/FVC%were significantly positively correlated with IL-2?P<0.05?;but not significantly correlated with IL-10.In another subgroup analysis,it was found that none of the AECOPD groups showed a significant correlation;in the SCOPD group,FVC was significantly negatively correlated with CRP and FIB?all P<0.05?;FVC was significantly correlated with IL-2 and IL-10 positive correlation?all P<0.05?,FEV₁%pred was significantly negatively correlated with FIB and TGF-??all P<0.05?,in healthy control group,FEV₁%pred was significantly negatively correlated with IL-10?P<0.05?.7.Peripheral blood CD4⁺CD25⁺FoxP3⁺T cell ratio test results:the proportion of CD4⁺CD25⁺FoxP3⁺T cells in AECOPD group was significantly lower than that in SCOPD group,the difference was statistically significant?P<0.05?,the proportion of CD4⁺CD25⁺FoxP3⁺T cells in SCOPD group were significantly lower than that in healthy control group,the difference was statistically significant?P<0.05?.Conclusions:1.T regulatory cells may be used as indicators of the stage of COPD disease.2.Consider that the increase of TGF-?level in peripheral blood serum can reflect the worsening of COPD patients.3.Consider that the increase of IL-2 level in peripheral blood serum can reflect the increase of Treg cell level in peripheral blood of COPD patients,which is expected to provide new ideas for the treatment of COPD.