Abstract:

Objective

To analyze the expression of regulatory T cells （Treg）/T helper cells 17（Th17） and dendritic cells （DC） in different progression stages of chronic obstructive pulmonary disease（COPD） and their relationships with prognosis.

Methods

The clinical data of 73 patients with COPD admitted to Suzhou Jiulong Hospital， Shanghai Jiaotong University School of Medicine from September 2019 to February 2023 were retrospectively analyzed. Among them， 35 patients in the acute exacerbation stage were included in the observation group， and 38 patients in the stable stage were included in the control group. The levels of CT image parameters ［percentage of wall area （WA%）， bronchial lumen area （Ai）］， Treg， Th17， Treg/Th17 and DC cells were detected， and the patients was divided into good prognosis （77 cases） and poor prognosis（18 cases） according to the follow-up results. The levels of Treg， Th17， Treg/Th17 and DC cells in stable group， exacerbation group and control group were compared； Spearman correlation coefficient was used to analyze the correlation between the levels of Treg， Th17， Treg/Th17， DC cells and the severity of COPD； the general data ［including sex， age， body mass index （BMI）， course of disease， underlying diseases］ and the levels of Treg， Th17， Treg/Th17 and DC cells of the good prognosis group and the poor prognosis group were compared； ROC analysis was used to analyze the value of Treg， Th17， Treg/Th17 and DC cells in evaluating the poor prognosis of patients.

Results

The Ai［（8.76±2.45） mm²］ of the observation group was significantly lower than that of the control group ［（14.97±3.61）mm²］， and the WA% （77.62±7.74） % was significantly higher than that of the control group ［（66.81±7.04） %］ （P＜0.05）. The levels of Treg， Treg/Th17 and DC cells in observation group ［（2.59±0.54） %， （0.41±0.11）， （1.38±0.41） %］ were significantly lower than those in control group ［（4.38±0.77） %， （0.82±0.26）， （2.52±0.82） %］， and the levels of Th17 in observation group ［（6.28±0.99）%］ were significantly higher than those in control group ［（5.32±0.63）%］（P＜0.05）. Treg， Treg/Th17 and DC cells were negatively correlated with the severity of the disease （r=-0.563，-0.571，-0.536， P＜0.05）， and Th17 was positively correlated with the severity of the disease （r=0.542， P＜0.05）. The levels of Treg， Treg/Th17 and DC cells in the good prognosis group ［（3.87±1.22） %，（0.69±0.21）， （2.33±0.52） %］ were significantly higher than those in the poor prognosis group ［（2.38±0.75）%， （0.34±0.11）， （1.92±0.32） %］， and the level of Th17 in the good prognosis group ［（5.64±1.15）%］ was significantly lower than that in the poor prognosis group ［（6.91±1.42） %］ （P＜0.05）. ROC results showed that the area under the curve of Treg， Th17， Treg/Th17 and DC cells to evaluate the poor prognosis of patients was 0.856， 0.702， 0.825 and 0.790， respectively（P＜0.05）.

Conclusion

The levels of Treg/Th17 and DC cells were highly expressed in both stable and acute exacerbations of COPD， and the levels of Treg/Th17 and DC cells in the good prognosis group were significantly higher than those in the poor prognosis group.

Key words: Chronic obstructive pulmonary disease, Regulatory T cell, T helper cell 17, Dendritic cell, Prognosis