Complement C3 depletion links to the expansion of regulatory T cells and compromises T-cell immunity in human abdominal sepsis: A prospective pilot study
Complement C3 depletion links to the expansion of regulatory T cells and compromises T-cell immunity in human abdominal sepsis: A prospective pilot study
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DOI：
10.1016/j.jcrc.2013.09.007
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发表时间：
2013-12-01
影响因子：
3.7
通讯作者：
Ren, Jianan
中科院分区：
文献类型：
--
作者：
Yuan, Yujie;Yan, Dongsheng;Ren, Jianan
目的：补体耗竭常见于脓毒症患者，但这一问题在治疗过程中往往被低估。本研究旨在确定补体耗竭和t细胞免疫抑制之间的关系。方法：2011年11月至2012年3月，前瞻性纳入单中心重度腹腔脓毒症患者。补体C3的基线水平将受试者分为两组。入院后不时监测血浆补体成分水平、调节性T细胞（Tregs）百分比和T细胞免疫指标。探讨C3耗竭与t细胞反应的关系，并探讨临床疗效。结果：共纳入60例患者，年龄43.9 +/- 11.3岁。65%的受试者出现C3消耗，与Treg扩张（P= 0.001）和CD4(+)/CD8（+）比值下降（P= 0.008）密切相关。这种消耗还与住院时间延长（P= 0.001）、手术时间延迟（P < 0.001）、术后并发症增加（P= 0.036）和住院费用（P < 0.001）有关。结论：补体C3消耗被发现与腹部败血症期间Tregs的扩张有关。在重症监护中应密切注意这种耗竭和相关的免疫抑制。(C) 2013爱思唯尔公司版权所有。
Purpose: Complement depletion commonly occurred in septic patients, but this problem was often underestimated during the treatment process. This study was designed to determine the association between complement depletion and T-cell immunosuppression.Methods: From November 2011 to March 2012, patients with severe abdominal sepsis were prospectively enrolled in a single center. The baseline levels of complement C3 were used to stratify subjects into 2 groups. Plasma levels of complement components, percentage of regulatory T cells (Tregs), and T-cell immunity indexes were monitored at times after admission. The relationship between C3 depletion and T-cell response was investigated, with clinical outcomes explored meanwhile.Results: A total of 60 patients aged 43.9 +/- 11.3 years were included within the period. C3 depletion, occurring in 65% of enrolled subjects, was strongly correlated with Treg expansion (P=.001) and decreased CD4(+)/CD8(+) ratio (P=.008). This depletion was also related to prolonged hospital stay (P=.001), delayed time to operation (P < .001), increased postoperative complications (P=.036), and hospital expenditure (P < .001).Conclusions: Complement C3 depletion was found to be linked to the expansion of Tregs during abdominal sepsis. Such depletion and associated immunosuppression should be paid close attention in the critical care. (C) 2013 Elsevier Inc. All rights reserved.