Blood Lymphocyte Subsets Research Articles

Circulating lymphocyte subsets are prognostic factors in patients with nasopharyngeal carcinoma

BackgroundNasopharyngeal carcinoma (NPC) is a geographically and racially variable disease that has a high incidence in Southeast China. According to previous studies on tumor immunity, we compared multiple clinical parameters and blood indexes with outcomes regarding to Epstein-Barr virus (EBV) status in NPC patients.MethodsAccording to the EBV load at diagnosis, 220 NPC patients who received concurrent chemoradiotherapy (CRT) were divided into two groups: EBV DNA ≥ 1500 copies/mL and EBV DNA < 1500 copies/mL, respectively. We compared clinical parameters with peripheral blood mononuclear cells, lymphocyte subsets and biochemical indexes. We also analyzed distant metastases and the overall survival rate regarding to these characteristics.ResultsIn most cases, the two groups showed the same trends. Most blood indexes were decreased during CRT and the decrease of the absolute count was more significant than the percentage. Patients with younger age showed the higher CD3+ and CD3 + CD8+ percentages. Patients whose EBV DNA ≥ 1500 copies/mL showed a higher N classification than those with EBV DNA < 1500 copies/mL at first diagnosis. Within patients with EBV DNA ≥ 1500 copies/mL, a higher CD3 + CD8+ percentage or lower CD3-CD56+ percentage had better OS rates, and the CD3 + CD8+ percentage was an independent prognostic factor by multivariate survival analyses.ConclusionsCRT caused an overall decrease of blood cells in NPC patients. Among all the blood indexes, the CD3 + CD8+ percentage showed a correlation with age and was an independent prognostic factor in patients with EBV DNA ≥ 1500 copies/mL at first diagnosis, which is worthy for further large cohort study.

Cytokine and Lymphocyte Profiles in Dogs with Atopic Dermatitis after Allergen-Specific Immunotherapy.

Canine atopic dermatitis (cAD) is a chronic and recurrent inflammatory and pruritic skin disease in dogs. Currently, allergen-specific immunotherapy (ASIT) is the only identified disease-modifying intervention for allergic diseases. It decreases the symptoms triggered by allergens and prevents recurrence of the disease in the long-term. The aim of our research was to determine how immunotherapy changes the proportion of lymphocyte subsets in dog peripheral blood and the levels of cytokines secreted by these cells during therapy. ASIT was applied for 6 months. Blood samples for further analyses were collected from patients in the third and sixth month of immunotherapy. Six out of seven dogs receiving ASIT showed a positive effect. A reduction in cytokine levels (IL-13, TNF-α) in peripheral blood of cAD patients and changes in the number of specific T cell subpopulations—reduction of Tc cells (CD8+) and increase of activated T cells (CD3+CD25+)—confirmed the beneficial effect of the applied ASIT. In addition, a significantly higher percentage of Treg cells (CD4+CD25+FOXP3+) was noted in cAD patients before treatment compared to healthy dogs. After 3 months of therapy, the percentage of Tregs significantly decreased, and after 6 months, it increased significantly again.

Role of CD4 + T and CD8 + T Lymphocytes-Mediated Cellular Immunity in Pathogenesis of Chronic Obstructive Pulmonary Disease.

This work was to explore the changes of T lymphocyte subsets in peripheral blood of patients with acute exacerbation of chronic obstructive pulmonary disease (COPD) (AECOPD) and the role of cellular immunity mediated in the disease process. Eighty-six patients with AECOPD who visited Qingdao Hiser Medical Center from June 2020 to December 2021 and 30 healthy people (controls) who underwent health examination in the same period were selected. The differences of pulmonary function (PF), arterial blood gas (ABG), blood routine inflammatory indexes, T lymphocyte and T lymphocyte subsets were compared between the two groups, and the correlation between T lymphocyte subsets and each index was analyzed. There were clear differences in PF, ABG, and PB inflammation indexes between AECOPD patients and the controls (P <0.05). Compared with the controls, the CD4+ and CD4+/CD8+ ratio in PB of AECOPD group were obviously decreased, and the CD8+ level was clearly increased (P <0.05); Th1 of CD4+ cell subsets and Tc1 of CD8+ cell subsets were significantly increased, while Th2 of CD4+ cell subsets and Tc2 of CD8+ cell subsets were obviously decreased (P <0.05). However, CD4+ was significantly positively correlated with lung function indexes, and significantly negatively correlated with neutrophils/lymphocytes and high-sensitivity C-reactive protein (P <0.05) and significantly positively correlated with Hs-CRP (P <0.05). In summary, CD4+ and CD8+ T lymphocytes were involved in the occurrence and occurrence of AECOPD, the decrease of CD4+ and the increase of CD8+ may promote the deterioration of COPD.

Screening for Immunodeficiencies in Children With Invasive Pneumococcal Disease: Six-year Experience From a UK Children's Hospital.

A previous study showed that investigation of children with invasive pneumococcal disease (IPD) revealed an immunodeficiency in up to 10% of cases. Following this report, we implemented a protocol to investigate children with IPD, to assess the proportion with an immunodeficiency in our setting. We retrospectively identified patients who presented with IPD from January 2015 to November 2020 and collected data from medical records. Immunological investigations included complement C3 and C4 levels, classical and alternative pathway complement function, IgG, IgA and IgM levels, specific IgG levels (H. influenza B, tetanus and pneumococcal serotypes), peripheral blood film, lymphocyte subsets, and CD62L-shedding upon activation with Toll-like receptor-agonists in selected cases. We identified a total of 68 children with IPD, with a mortality of 6%. Immunological investigations were performed in 51 children. Four children (8%) had abnormal findings that were deemed of clinical significance. Two children had complement deficiencies (Factor I and C2 deficiency), one child had specific antibody deficiency, and another child had low IgM, low NK-cells and poor persistence of serotype-specific anti-pneumococcal IgG concentrations. Of the 17 children with IPD who were not tested for immunodeficiencies, 4 died and four had possible explanations for the infection. We identified clinically relevant abnormal immunological findings in 4/51 (8%) of children with IPD. Our results support the recommendation to perform immunological investigations in children with IPD, since this might reveal underlying immunodeficiencies, allowing for necessary preventive measures and close follow-up.

Characteristics and significance of T lymphocyte subsets in peripheral blood of osteosarcoma mice.

BackgroundOsteosarcoma (OS) is the most common malignant bone tumor, which often has lung metastasis. The survival rate after tumor metastasis is very low. Treatments including the antitumor immunocompetence of innate immune cells are found favorable for OS tumor. However, as a major means of early tumor detection, there are still few studies on T cells in peripheral blood of OS patients.MethodsOS cells were implanted into the femoral bone marrow cavity of C3H/HeN mice to construct OS model. The proportion of T lymphocyte subsets in peripheral blood of mice was detected by flow cytometry on the 14th and 21st days after modeling.ResultsCompared with sham operation group, on the 14th day after operation, the proportion of γδT cells and CD4+ regulatory T cells (Tregs) showed significantly higher level while other subsets didn’t have obvious difference. On the 21st day after operation, the proportion of CD3+ T cells, γδ T cells, CD4+ Tregs and Tregs/Th17 ratio were obviously higher than that of sham operation group. Meanwhile, while CD4+ T cells and CD8+ T cells were lower, suggesting the happen of peripheral immunosuppression. Comparing the T lymphocytes subsets on the 14th and 21st day after modeling in the tumor group, it was found that CD3+ T cells and CD4+ Tregs on the 21st day after modeling were significantly higher than those on the 14th day while CD4+ T cells, CD8+ T cells decreased significantly, indicating the changes of T lymphocytes in peripheral blood of OS mice are related to tumor development.ConclusionsThe formation and development of femoral OS is accompanied by the disorder of peripheral blood T lymphocyte subsets and peripheral immunosuppression.

Preliminary Study on the Imbalance Between Th17 and Regulatory T Cells in Antiphospholipid Syndrome.

ObjectivePatients with antiphospholipid syndrome (APS) have immune cell abnormalities that remain poorly understood. This study compared primary APS (PAPS) and secondary APS (SAPS) patients with healthy controls with respect to peripheral blood lymphocytes, CD4+T cell subsets, and cytokine levels. The correlation between antiphospholipid antibody titres and T helper 17 (Th17) and T regulatory (Treg) cell subsets was also analyzed, together with the correlations between cytokine profiles and the clinical characteristics of APS patients.MethodsThe retrospective study population consisted of 67 APS patients (12 with PAPS, 55 with SAPS) and 40 healthy controls. Absolute numbers of peripheral blood lymphocyte subsets and CD4+ T cell subsets were detected by flow cytometry, and serum cytokine levels by flow cytometry bead array.ResultsPatients with SAPS had lower absolute values of T, B and CD4+T cells than the healthy control group, while only natural killer (NK) cell levels were decreased in patients with PAPS. Absolute numbers of T, B, NK, and CD4+T cells were significantly higher in the PAPS than SAPS group. The trends in CD4+T cell subsets were the same in PAPS and SAPS patients as in healthy controls, with increased Th1, decreased Th2, and decreased Treg levels, and thus an increased Th17/Treg ratio. Th2, Th17, and Treg cell counts were higher in the PAPS than SAPS group. Cytokine analysis showed that only IL-10 levels differed between the two APS groups. However, the levels of all of the studied cytokines were higher in APS patients than healthy controls, and correlated with the clinical characteristics of the patients. In the PAPS group, the titres of two autoantibodies correlated positively with the Th17/Treg ratio and negatively with the levels of D-dimer and Treg subsets.ConclusionsOur study clearly showed that APS patients have immune disturbances, the most prominent of which is an increase in the Th17/Treg ratio, due to a decrease in the number of Treg cells. These abnormalities may be involved in the occurrence and progression of APS. An additional finding was a higher level of peripheral blood lymphocytes in PAPS than SAPS patients, which may be related to the immunosuppressive treatment of SAPS patients.

The relationship between absolute counts of lymphocyte subsets and clinical features in patients with pulmonary tuberculosis.

BackgroundThe aim of the present study is to investigate the clinical value and characteristics of peripheral blood lymphocyte subsets in patients with pulmonary tuberculosis (PTB) using flow cytometry.MethodsThe absolute counts of T, CD4+T, CD8+T, natural killer (NK), NKT and B lymphocytes in 217 cases of PTB were detected, and the variations in lymphocyte subset counts between different ages and genders and between aetiological detection results and chest radiography results were analysed.ResultsIn 75.3% of the patients with PTB, six subset counts were lower than the normal reference range, and 44% showed lower‐than‐normal CD4+T lymphocyte levels. The counts of T, CD4+T, CD8+T and B lymphocytes were significantly lower in patients aged >60 years, and the NKT cell counts were significantly lower in female patients than in male patients. Among the patients with positive aetiological results, 40.8% had reduced CD8+T counts; these were significantly lower than those in patients with negative aetiological results (P = 0.0295). The cell counts of T, CD4+T, CD8+T and B lymphocytes reduced as lesion lobe numbers increased. The counts of T, CD4+T and CD8+T lymphocytes were significantly higher in the group with lesions affecting one lobe than in the groups with two to three lobes or four to five lobes, and the counts of B lymphocytes were significantly higher in the group with one lobe and the group with two to three lobes than in the group with four to five lobes. The counts of CD4+T and CD8+T lymphocytes were highest in the no cavity group and showed a downward trend with the increase in cavities; the T lymphocyte count was significantly higher in the no cavity group than in the group with five or more cavities (P = 0.014), and the CD8+T lymphocyte count was significantly higher in the no cavity group than in the group with one to two cavities and the group with five or more cavities (P = 0.001 and 0.01, respectively).ConclusionsIn most patients with tuberculosis, immune function is impaired. The absolute counts of peripheral blood lymphocyte subsets are closely related to the aetiological results and lesion severity in patients with PTB; this could be used as evidence for immune intervention and monitoring curative effects.

Lymphopenia in patients affected by SARS-CoV-2 infection is caused by margination of lymphocytes in large bowel: an [18F]FDG PET/CT study

BackgroundTo investigate the cause of lymphopenia in patients with newly diagnosed COVID-19, we measured [18F]FDG uptake in several tissues, including the ileum, right colon, and caecum at diagnosis and after recovery and correlated these measurements with haematological parameters.MethodsWe studied, by [18F]FDG PET/CT, 18 newly diagnosed patients with COVID-19. Regions of interest were drawn over major organs and in the terminal ileum, caecum, and right colon, where the bowel wall was evaluable. Five patients were re-examined after recovery, and three of them also performed a white blood cell scan with 99mTc-HMPAO-WBC on both occasions. Complete blood count was performed on both occasions, and peripheral blood lymphocyte subsets were measured at diagnosis. Data were analysed by a statistician.ResultsPatients had moderate severity COVID-19 syndrome. Basal [18F]FDG PET/CT showed focal lung uptake corresponding to hyperdense areas at CT. We also found high spleen, ileal, caecal, and colonic activity as compared to 18 control subjects. At recovery, hypermetabolic tissues tended to normalize, but activity in the caecum remained higher than in controls. Regression analyses showed an inverse correlation between CD4 + lymphocytes and [18F]FDG uptake in the caecum and colon and a direct correlation between CD8 + lymphocytes and [18F]FDG uptake in lungs and bone marrow. WBC scans showed the presence of leukocytes in the caecum and colon that disappeared at recovery.ConclusionsThese findings indicate that lymphopenia in COVID-19 patients is associated with large bowel inflammation supporting the hypothesis that CD4 + lymphocytes migrate to peripheral lymphoid tissues in the bowel.

Association of lymphocyte subsets with efficacy and prognosis of immune checkpoint inhibitor therapy in advanced non-small cell lung carcinoma: a retrospective study

BackgroundImmune checkpoint inhibitors (ICIs) have achieved promising effects in patients with non-small cell lung cancer (NSCLC). However, not all patients with NSCLC benefit from immunotherapy. There is an urgent need to explore biomarkers that could predict the survival outcomes and therapeutic efficacy in advanced NSCLC patients treated with immunotherapy. In this study, we aimed to assess the changes in peripheral blood lymphocyte subsets and their association with the therapeutic efficacy and clinical prognosis of advanced NSCLC patients treated with immunotherapy.MethodsA total of 276 patients with advanced NSCLC were enrolled. Peripheral blood lymphocyte subsets including CD4+ T cells, CD8+ T cells, CD4+/CD8+ ratio, NK cells, Tregs and B cells were collected before any treatment, before immunotherapy or chemotherapy, and after 4 cycles of immunotherapy or chemotherapy. T-test was used to analyze the factors influencing lymphocyte subsets and their changes before and after therapy. Logistic regression was used to plot ROC curves and analyze the relationship between lymphocyte subsets and therapeutic efficacy. Log-rank test and Cox regression model were used to evaluate the relationship between lymphocyte subsets and progression-free survival (PFS).ResultsGender, distant metastasis, and EGFR mutation status are known to affect the proportion of peripheral blood lymphocyte subsets in patients with advanced NSCLC. The proportions of CD4+ T cells, CD8+ T cells, Tregs and B cells were found to decrease after chemotherapy as compared to the baseline. The proportion of CD4+ T cells, CD8+ T cells, CD4+/CD8+ ratio, NK cells and Tregs were higher after immunotherapy than after chemotherapy. Compared to the baseline, the effective group showed significant increase in the proportions of CD4+ T cells, CD4+/CD8+ ratio, NK cells and Tregs, and the number of CD8+ T cells was significantly lower in the peripheral blood after 4 cycles of immunotherapy. On the contrary, the ineffective group did not show any significant differences in the above parameters. Baseline CD4+ T cells and NK cells were independent predictors of immunotherapy efficacy and PFS. Baseline Tregs were independent predictor of immunotherapy efficacy.ConclusionImmune checkpoint inhibitors induced changes in the proportion of peripheral blood lymphocyte subsets in patients that responded well to immunotherapy. The levels of the different lymphocyte subsets could serve as valuable predictive biomarkers of efficacy and clinical prognosis for NSCLC patients treated with immunotherapy.

The dynamics of Th17 / Treg ratio in SLE patients during pregnancy

Systemic lupus erythematosus (SLE) is a multisystemic autoimmune disorder that affects women at childbearing age. During pregnancy, maternal immune system is challenged to tolerate a semi-allogenic fetus and a shift toward a tolerogenic profile is essential. Failure to develop this tolerogenic profile seems to be associated with the development of adverse obstetric outcomes. We conducted a prospective longitudinal observational study where peripheral blood lymphocyte subsets were analyzed during pregnancy in a group of SLE patients and compared with healthy gestations. We observed a reduction in peripheric Treg cell count throughout all pregnancy in control patients, which was not observed in SLE patients. In contrast, the Th17 cell count remained stable in both groups. In the control group, the Treg/Th17 ratio decreased throughout pregnancy to the postpartum, which was not observed in the study group. These changes may be justified by the migration of the immunotolerant Treg cells to the maternal decidua and may lead to the establishment of a pro-inflammatory profile by the end of pregnancy in healthy pregnancies, which was not observed in the SLE pregnant patients. This pro-inflammatory state at the end of a healthy pregnancy may be necessary for the spontaneous beginning of labor and help to explain why systemic syndromes like preeclampsia develop during the second half of pregnancy. The lack of these findings in SLE patients may express a pro-inflammatory state from the beginning of pregnancy, the influence of immunomodulatory medication or an intrinsic deregulation of immune function, which is a characteristic of these patients.

Impact of Perioperative Multiple Doses of Glucocorticoids on Peripheral Blood Lymphocyte Subsets and Inflammatory Cytokines in Patients With Non-small Cell Lung Cancer.

PurposeSurgery-induced immunosuppression is associated with infectious complications and cancer recurrence. This study aimed to characterize the effects of perioperative multiple doses of glucocorticoids on the peripheral immune environment in patients with non-small cell lung cancer.MethodsIn this retrospective study, surgical patients with lung cancer were included. Lymphocyte subsets, lymphocyte phenotypes, lymphocyte functions, and inflammatory cytokines were evaluated in the peripheral blood preoperatively, then at 1 day and 7 days postoperatively. Levels of immune cells and inflammatory factors were compared between those who did or did not receive glucocorticoids at all time points.ResultsMultiple doses or high doses (15–20 mg dexamethasone equivalents) of glucocorticoids that were all given within 24 h were associated with decreased absolute numbers of T cells, CD4+and CD8+T cells, B cells, and impaired T cells function at 1 day postoperatively while a single intraoperative low dose (5 mg) of dexamethasone had little influence on the peripheral environment. IL-1β, IL-6, and TNF-α were also more affected by multiple doses of glucocorticoids.ConclusionsAmong patients with lung cancer, perioperative multiple doses of glucocorticoids that are all given within a short time are associated with decreased immune cell counts and impaired T cells functions.

Effect of Double-Channel Anastomosis and Esophagojejunal Anastomosis on Postoperative Recovery and Complications of Laparoscopic D2 Radical Gastrectomy for Gastric Cancer.

The aim of this study was to investigate the effects of double-channel anastomosis versus esophagojejunostomy on postoperative recovery and complications after laparoscopic D2 radical gastrectomy for early proximal gastric cancer. The cases were collected from 100 patients with early proximal gastric cancer admitted to our hospital from January 2017 to January 2021. According to different surgical methods, they were divided into control group (total gastrectomy + esophagojejunal anastomosis) and experimental group (D2 radical resection + double-channel anastomosis). The two groups were compared in terms of clinical outcomes (operative time, intraoperative blood loss, number of lymph nodes dissected, digestive tract anastomosis time, postoperative exhaust, and hospitalization days), postoperative complications, and nutritional status; the expression of T lymphocyte subsets in peripheral blood of the two groups was detected to reflect the recovery of immune ability. There was no significant difference between the observation group and the control group in clinical operation effect indexes (P < 0.05). The incidence of complications of dumping syndrome and reflux esophagitis in the observation group was significantly lower than that in the control group (P < 0.05). In terms of postoperative nutritional status, the ratio of plasma albumin level and body weight restored to operation at 12 and 24 weeks after operation in the observation group was significantly higher than that in the control group (P < 0.05). 3 months after the operation, the levels of CD3 +, CD4 + cell subsets, and CD4+/CD8+ index reflecting the recovery of immune ability in the observation group were significantly higher than those in the observation group (P < 0.05). The application of double-channel anastomosis in laparoscopic D2 radical gastrectomy for early proximal gastric cancer has a better effect on reducing complications and promoting postoperative recovery, which is of great application value.

Regulatory T cells in children with attention deficit hyperactivity disorder: A case-control study

ObjectiveThe pathophysiology of attention deficit hyperactivity disorder (ADHD) are still not fully elucidated. Immune system dysregulation has emerged as a major etiological focus as a result of the high comorbidity of allergic disease, inflammatory biomarkers, and genetic research. The present study aimed to evaluate peripheral lymphocyte subpopulations and regulatory T cells (Tregs) in children with ADHD. MethodsThis single-center cross-sectional case-control study assessed 49 children with ADHD and 35 age- and gender-matched healthy children aged 7–12 years (9.10 ± 2.37 and 9.45 ± 2.13, respectively). The participants were screened for psychopathology using the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children–Present and Lifetime Version, while the severity of ADHD symptoms was measured by means of the distracted-Continuous Performance Test. Peripheral lymphocyte subpopulations and Tregs were analyzed with flow-cytometry. ResultsThere is no significant difference in peripheral blood lymphocyte subsets between ADHD and control groups The children diagnosed with ADHD exhibited significantly higher levels of CD3+ CD4+ CD25+ Foxp3+ (Tregs) than the healthy control subjects (8.23 ± 2.09 vs. 6.61 ± 2.89; z = 2.965, p = .004). The Tregs cell (Exp(B) = 1.334; p = .042; CI = 1.011–1.761) levels were determined to be statistically significant according to regression analysis and were associated with an increased probability of ADHD. ConclusionElevated Treg levels were linked to an increased likelihood of ADHD. This study suggested that changes in immune regulatory cells represent an important part of research in treatment of ADHD.

Lymphocyte Subsets in Mild COVID-19 Pediatric Patients.

Objective: The reasons for a high prevalence of asymptomatic or mild coronavirus disease (COVID-19) and rare severe disease in children have been explained by non-immune and immune mechanisms. This study aimed to evaluate the immune system’s response to severe acute respiratory syndrome coronavirus 2 by investigating lymphocyte subsets.Materials and Methods: This study included 33 coronavirus disease positive children, of whom 12 had mild disease and 21 had an asymptomatic infection as the patient group and 26 age- and gender-matched healthy children as the control group. The demographic information, symptoms, physical examination findings, complete blood count, C-reactive protein (CRP), procalcitonin, and lymphocyte subsets were recorded in all subjects.Results: Leukocyte, lymphocyte, monocyte count, and hemoglobin levels of our pediatric coronavirus disease patients were similar to the control group. Neutrophil was lower in the coronavirus disease cases compared to the control group. CRP and procalcitonin levels of asymptomatic cases were similar to the control group. B cell count, CD8+ T cell count, and CD4/CD8 ratio (dividing the CD4 cell count by the CD8 cell count) ratio were similar in the patient and control groups. Natural killer, T cell, and CD4+ T cell counts were significantly higher in the whole patient group compared to the control group.Conclusion: One reason for mild severe acute respiratory syndrome coronavirus 2 infection in children may be an increase in some lymphocyte subsets such as natural killer cells, T cell, and CD4+ T cell. Understanding the answer to the question of why children develop more protective immunity to the virus could be an essential step for developing new treatments.

Effect of intravenous lidocaine infusion on perioperative cellular immunity and the quality of postoperative recovery in breast cancer patients: a randomized controlled trial.

Breast cancer has become the most common malignancy worldwide. Experimental and, retrospective, clinical data indicate that anaesthetic technique might influence the risk of metastasis after cancer surgery by modulating the immune system. The purpose of this study is to investigate the effect of perioperative lidocaine injection on immune cells such as T lymphocytes and natural killer cells (NK cells) and the quality of postoperative recovery in breast cancer patients and to propose new ideas and relevant theoretical evidence for the selection of anesthetic protocols for perioperative tumor patients. Women (n=68) undergoing primary breast tumour resection were randomly assigned to received 2% lidocaine (n=34; group L) or placebo (normal saline; n=34; group S). Venous blood was collected thirty minutes before surgery (T0), after tumor removal (T1), immediately after surgery (T2), 24 h after surgery (T3), and 48 h after surgery (T4). The percentages of NK cells and T lymphocyte subsets (CD3+, CD4+, CD8+, CD4+/CD8+) in peripheral blood were detected by flow cytometry. Patients' quality of recovery-15 (QoR-15) scores were recorded by questionnaire before and 24 h after the operation, as well as intraoperative propofol and remifentanil dosages, the frequency of 24 h postoperative remedial analgesia, and the incidence of nausea and vomiting, dizziness, and chest tightness. There were 62 patients included in the study, and 60 patients were finally analyzed. The difference in the changing trend of NK cell levels in the 2 groups over time was statistically significant (F=7.675, P=0.008). The intraoperative changing trends of CD3+ T cells, CD4+ T cells, and the CD4+/CD8+ ratio over time differed significantly between the 2 groups of patients (P<0.05), whereas the trends of CD8+ T cells did not differ significantly (P>0.05). The QoR-15 score at 24 h after surgery was higher in Group L (128.50±20.25) than in Group S (117.50±19.50), and the difference was statistically significant (P=0.005). No adverse events such as cardiac arrhythmia and lidocaine toxicity occurred in both groups during the perioperative period. Continuous intravenous pumping of lidocaine during the perioperative period has little effect on immune function in breast cancer patients and promotes postoperative recovery. Chinese Clinical Trial Registry ChiCTR2100050445.

The Role of Lymphocyte Subset in Predicting Allograft Rejections in Kidney Transplant Recipients

Allograft rejection remains a significant challenge in managing post-transplant recipients despite the improvement in immunologic risk assessment and immunosuppressive therapy. Published literature including animal studies has demonstrated that the cells responsible for rejection are beyond the innate T and B cells, and other studies revealed evidence supporting natural killer (NK) cells' role in kidney allograft injury. This study aims to find the association between the peripheral blood lymphocyte subset counts, primarily NK cells, and the kidney allograft biopsy findings. This is a prospective cross-sectional study among a total of 100 kidney allograft biopsies in 61 kidney transplant recipients. The peripheral blood for the lymphocyte subset was sent just before the allograft biopsy. The patients' immunosuppression and other laboratory investigations were managed as per clinical practices by the attending nephrologist. Overall, the mean age of our patients was 43.72 ± 10.68 years old, and 55.7% of recipients were male. Higher counts of T cells (CD4+; 658.8 ± 441.4 cells/µL; P = .043) and NK cells (CD3-CD16+CD56+; 188 [interquartile range = 133.0-363.0 cells/µL]; P = .002) were associated with higher risk of allograft rejection in the initial analysis. Patients with an allograft age <12 months had significantly higher total T cells, CD4+ T cells, and NK cells in the rejection groups. However, after assessing factors associated with rejection in the multivariate analysis, we only found that being ABO-incompatible and having >497 CD4+ cells/µL had a higher odds of allograft rejection. Higher CD4± counts were associated with a higher risk of allograft rejection. However, there was no significant increase in CD8±, CD19±, and NK cells count in our cohort with allograft rejection.

Urinalysis, but Not Blood Biochemistry, Detects the Early Renal Impairment in Patients with COVID-19.

Background: Coronavirus 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus (SARS-CoV-2), has created a tremendous economic and medical burden. The prevalence and prognostic value of SARS-CoV-2-induced kidney impairment remain controversial. The current study aimed to provide additional evidence on the incidence of acute kidney injury (AKI) in COVID-19 patients and propose the use of urinalysis as a tool for screening kidney impairment. Methods: 178 patients with confirmed COVID-19 were enrolled in this retrospective cohort study. The laboratory examinations included routine blood tests, blood biochemical analyses (liver function, renal function, lipids, and glucose), blood coagulation index, lymphocyte subset and cytokine analysis, urine routine test, C-reactive protein, erythrocyte sedimentation, and serum ferritin. Results: No patient exhibited a rise in serum creatinine or Cystatin C and occurrence of AKI, and only 2.8% of patients were recorded with an elevated level of blood urea nitrogen among all cases. On the contrary, 54.2% of patients who underwent routine urine testing presented with an abnormal urinalysis as featured by proteinuria, hematuria, and leucocyturia. Conclusions: Kidney impairment is prevalent among COVID-19 patients, with an abnormal urinalysis as a clinical manifestation, implying that a routine urine test is a stronger indication of prospective kidney complication than a blood biochemistry test.

Antibody responses to 2 doses of mRNA COVID-19 vaccine in pediatric patients with kidney diseases

Antibody responses to 2 doses of mRNA COVID-19 vaccine in pediatric patients with kidney diseases

Changes in bone marrow and peripheral blood lymphocyte subset findings with onset of hepatitis-associated aplastic anemia.

Rationale:Hepatitis-associated aplastic anemia (HAAA) is a rare illness that results in bone marrow failure following hepatitis development. The etiological agent remains unknown in most HAAA cases. However, clinical features of the disease and immunotherapy response indicate that immune-mediated factors play a central role in the pathogenesis of HAAA. Activation of cytotoxic T cells and increase in CD8 cells could exert cytotoxic effects on the myelopoietic cells in the bone marrow.Patient concerns:A 15-month-old boy was brought to our hospital with complaints of generalized petechiae and purpura observed a week prior to hospitalization. His liver was palpated 3 cm below the costal margin, platelet count was 0 × 104/μL, and alanine aminotransferase level was 1346 IU/L. A blood test indicated cytomegalovirus infection, and 3 bone marrow examinations revealed progressive HAAA. As the disease progressed to the 3rd, 6th, and 9th week after onset, CD4+ T cells were markedly decreased, CD8+ T cells were markedly increased, and the CD4/CD8 ratio was significantly decreased. The number of B cells and natural killer cells decreased with time, eventually reaching 0.0%.Diagnosis:HAAA.Interventions:Rabbit antithymocyte globulin and eltrombopag olamine (a thrombopoietin receptor agonist) were administered.Outcomes:The patient's platelet count returned to normal, and bone marrow transplantation was avoided. The peripheral blood lymphocytes (PBLs) improved as the patient's general condition recovered.Lessons:This case demonstrates that HAAA induced by cytomegalovirus infection features decreasing CD4+ and increasing CD8+ PBLs as the bone marrow hypoplasia progresses. The PBLs return to their normal levels with the recovery from the disease. Our case findings thus support the involvement of immunological abnormality in HAAA.

Persistent Changes of Peripheral Blood Lymphocyte Subsets in Patients with Oral Squamous Cell Carcinoma

Background: Oral squamous cell carcinoma (OSCC) is a common cancer with high morbidity and mortality. Alterations of antitumor immune responses are involved in the development of this malignancy, and investigation of immune changes in the peripheral blood of OSCC patients has aroused the interest of researchers. Methods: In our study, we assessed the proportions of CD3+ total T lymphocytes, CD3+CD4+ helper T lymphocytes, CD3+CD8+ suppressor/cytotoxic T lymphocytes, CD3−CD19+ total B lymphocytes, and CD3−CD16+CD56+ NK cells in the peripheral blood of OSCC patients. Results: The data obtained both pre- and post-therapy showed a similar level of total CD3+ T lymphocytes in OSCC patients and control subjects, pinpointing the stability of this immune parameter. On the other hand, pre-therapeutic data showed a lower proportion of helper T lymphocytes (CD4+), a significantly higher level of cytotoxic/suppressive T lymphocytes (CD8+), and a much lower CD4+ T lymphocyte/CD8+ T lymphocyte ratio compared to control subjects. Conversely, evaluation of circulating NK (CD16+) cells showed a markedly higher pre-therapeutic level compared to the control group. Conclusions: Our results related to immune changes in the peripheral blood add new information to this complex universe of connections between immuno-inflammatory processes and carcinogenesis.