Peripheral blood T-lymphocyte subsets are potential biomarkers of disease severity and clinical outcomes in patients with ulcerative colitis: a retrospective study.
Peripheral blood T-lymphocyte subsets are potential biomarkers of disease severity and clinical outcomes in patients with ulcerative colitis: a retrospective study.
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外周血 T 淋巴细胞亚群是溃疡性结肠炎患者疾病严重程度和临床结果的潜在生物标志物：一项回顾性研究。
DOI：
10.1186/s12876-023-02769-5
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发表时间：
2023-04-27
影响因子：
2.4
通讯作者：
Guo, Jing
中科院分区：
文献类型：
--
作者：
Geng, Bailu;Ding, Xueli;Li, Xiaoyu;Liu, Hua;Zhao, Wenjun;Gong, Haihong;Tian, Zibin;Guo, Jing
溃疡性结肠炎（UC）被认为是一种免疫介导的疾病。 T淋巴细胞亚群紊乱在UC的发病机制中发挥着重要作用。本研究的目的是评估外周血 T 淋巴细胞亚群在评估 UC 患者疾病严重程度和预测临床结果方面的意义。这项回顾性病例对照研究在 116 名患有活动性疾病的 UC 患者和 90 名健康对照 (HC) 中进行。对纳入的 UC 患者进行了 180 天的随访。进行了 t 检验、Spearman 相关系数、多变量 Cox 回归分析、受试者工作特征 (ROC) 曲线和累积生存分析的分析。与HC组相比，UC组CD4+T细胞比例较低（42.85%±9.77% vs 45.71%±7.94%，P=0.021），CD8+T细胞比例较高（27.88%±8.86% vs 25.00%±6.47%，P=0.008）。严重活动性UC患者CD3+HLA-DR+ T细胞比例较高（8.83%±6.55% vs 2.80%±1.55%，P<0.001；8.83%±6.55% vs 4.06%±5.01%，P<0.001）和CD8+T细胞比例较高（31.35%±8.49% vs轻度组和中度组分别为26.98%±7.98%，P=0.029；31.35%±8.49% vs 25.46%±9.15%，P=0.003），CD4+CD25+T细胞比例低于轻度组和中度组（2.86%±1.35% vs 3.46%±1.07%，P=0.034）。 CD4+T细胞（40.40%±9.36% vs 44.73%±10.39%，P=0.049）高于中等组。 CD3+HLA-DR+T细胞评估严重活动性UC的曲线下面积（AUC）为0.885，截止值为5.33%。敏感性为76.32%，特异性为89.74%。 CD3+HLA-DR+T细胞与CRP联合具有较强的评估价值，AUC为0.929。 CD8+T细胞、CD4+/CD8+比值和CD4+CD25+T细胞评估疾病严重程度的AUC分别为0.677、0.669和0.631。随访180天内，24例患者（20.69%）发生UC相关再入院或手术，其中CD3+HLA-DR+ T细胞比例较高（10.66%±9.52% vs 3.88%±2.56%，P=0.003）和CD8+T细胞比例较高（31.19%±10.59% vs 27.01%±8.20%）， P=0.039）高于没有再次入院和手术的患者。 CD3+HLA-DR+ T细胞比例是UC相关再入院或手术的独立预测因子（HR=1.109，P=0.002）。 CD3+HLA-DR+T细胞预测再入院或手术的AUC为0.796，截止值为5.38%。 CD3+HLA-DR+T细胞比例>5.38%的UC患者再入院或手术时间较短（时序检验，P<0.001）。 CD3+HLA-DR+T 细胞和 CRP 的组合可能是 UC 患者疾病严重程度的潜在生物标志物。高比例的 CD3+HLA-DR+T 细胞可能与 UC 患者再入院或手术风险增加有关。
Ulcerative colitis (UC) is considered an immune-mediated disease. The disorder of T-lymphocyte subsets plays an important role in the pathogenesis of UC. The aim of this study was to evaluate the significance of peripheral blood T-lymphocyte subsets in assessing disease severity and predicting clinical outcomes in UC patients. The retrospective case-control study was performed in 116 UC patients with active disease and 90 healthy controls (HC). The UC patients included were followed up for 180 days. Analyses of t-test, Spearman’s correlation coefficient, multivariable Cox regression analysis, receiver operating characteristic (ROC) curves and cumulative survival analysis were done. The UC patients had lower proportions of CD4+T cells (42.85%±9.77% vs 45.71%±7.94%, P=0.021) and higher proportion of CD8+T cells (27.88%±8.86% vs 25.00%±6.47%, P=0.008) than HC. The severely active UC patients had higher proportion of CD3+HLA-DR+ T cells (8.83%±6.55% vs 2.80%±1.55%, P<0.001; 8.83%±6.55% vs 4.06%±5.01%, P<0.001) and CD8+T cells (31.35%±8.49% vs 26.98%±7.98%, P=0.029; 31.35%±8.49% vs 25.46%±9.15%, P=0.003) than mild and moderate group, whereas lower proportion of CD4+CD25+T cells (2.86%±1.35% vs 3.46%±1.07%, P=0.034) than mild group and CD4+T cells (40.40%±9.36% vs 44.73%±10.39%, P=0.049) than moderate group. The area under the curve (AUC) of CD3+HLA-DR+ T cells for assessing severely active UC was 0.885, with the cut-off value of 5.33%. The sensitivity was 76.32% and specificity was 89.74%. The combination of CD3+HLA-DR+ T cells and CRP had stronger assessment value with AUC of 0.929. The AUC of CD8+T cells, CD4+/CD8+ ratio and CD4+CD25+T cells for assessing disease severity was 0.677, 0.669 and 0.631 respectively. Within the 180 days follow-up, 24 patients (20.69%) had UC-related readmission or surgery, with higher proportion of CD3+HLA-DR+ T cells (10.66%±9.52% vs 3.88%±2.56%, P=0.003) and CD8+T cells (31.19%±10.59% vs 27.01%±8.20%, P=0.039) than those without readmission and surgery. The proportion of CD3+HLA-DR+ T cells was the independent predictor of UC-related readmission or surgery (HR=1.109, P=0.002). The AUC of CD3+HLA-DR+ T cells for predicting readmission or surgery was 0.796 with the cut-off value of 5.38%. UC patients with CD3+HLA-DR+T cells proportion>5.38% had a shorter time to readmission or surgery (log-rank test, P<0.001). The combination of CD3+HLA-DR+T cells and CRP may be potential biomarker of disease severity in UC patients. The high proportion of CD3+HLA-DR+T cells may be associated with an increased risk of readmission or surgery in UC patients.
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