Variety and clinical significance of T lymphocyte subsets and cytokines in the peripheral blood of patients with avian influenza H7N9 virus infection / 中华传染病杂志

ABSTRACT

Objective To investigate the changes and clinical significance of peripheral blood T lymphocyte subsets and cytokines in influenza A (H7N9) virus infection patients.Methods Twenty-three patients with H7N9 virus infection who received treatment at the First Affiliated Hospital of Soochow University from April 2013 to April 2015 were enrolled as case group.Twenty healthy subjects in the outpatient clinic during the same period were selected as control group.The percentages of T lymphocyte subsets in the peripheral blood including CD3+CD4+ T cells, CD3+CD8+ T cells, regulatory T lymphocytes (Treg), Th17, CD3+CD8-interferon (IFN)-γ+ (Th1) cells and CD3+CD8-IL-4+ (Th2) cells were detected by flow cytometry.The changes of plasma cytokines including interleukin (IL)-8, IL-18, interferon-inducible protein (IP)-10, macrophage inflammatory protein (MIP)-1b were quantified by Bio-Plex Pro human cytokine Group Ⅰ 27-plex panel and Group Ⅱ 21-plex panel.The normality test was performed by Kolmogorov-Smirnov test.Two independent samples t test were used to compare the two groups.Results The percentages of CD3+CD4+ and CD3+CD8+ T cells before treatment in case group were significantly lower than control group ([27.90±10.19]% vs [38.75±6.78]%, t=-2.726, P=0.012;[14.82±7.72]% vs [22.79±6.12]%, t=-2.556, P=0.018), while the percentages of Th17 and Th2 before treatment in case group were significantly higher than control group ([2.64±1.40]% vs [0.29±0.21]%, t=4.668, P0.05).Before treatment, levels of IL-8, IL-18, IP-10 and MIP-1b of case group were significantly higher than those in control group (IL-8 [23.19±14.35] vs [12.78±6.76] ng/L, t=2.277, P=0.035;IL-18[230.55±230.18] vs [72.80±27.91] ng/L, t=2.348, P=0.036;IP-10[28 870.55±41 815.22] vs [1 356.13±1 093.10] ng/L, t=2.371, P=0.035;MIP-1b [197.74±119.87] vs [118.51±41.86] ng/L, t=2.198, P=0.043).Conclusions Patients with H7N9 virus infection exhibit an imbalance of T lymphocyte subsets.It is very important to monitor the changes of T lymphocyte subsets in those patients for clinical prognosis.A storm of cytokines could exist during H7N9 virus infection, which may be the main reason for multiple organ failure.