The change ofCD4+CD25+ Treg and it’s effect on cell cellular immunity in patients with systemic inflammatory response syndrome due to severe multiple trauma_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

ZHANG Lina ,  WU Tiejun , TIAN Hui

Intensive Care Unit，Liaocheng People’s Hospital.Liaocheng，Shandong，252000，ChinaCorresponding author：WU Tie-jun，E-mail：tiejunwu@hotmail.com;

Corresponding author：

WU Tiejun, Email: tiejunwu@hotmail.com

Keywords：

Multiple trauma; Systemic inflammatory response syndrome; Regulatory T cells; Infection

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Objective To investigate the percentage of CD4+CD25+ Treg in peripheral blood of patients with severe multiple trauma and systemic inflammatory response syndrome（SIRS） and its effects on cellular immunity and secondary infection.Metheds Peripheral blood of 23 patients with severe multiple trauma was collected in 24 h after SIRS was diagnosed，and flow cytometry was used to determine the percentage of CD4+CD25+ Treg and CD4/CD8 ratio.Simultaneously，in order to explore the cell proliferation，silver staining was used to determine Ag-NORs of leukomonocyte in peripheral blood represented by IS%.In order to investigate the infection in patients，sputum and secretion sample were collected for bacteriological examination on 1 and 5 day after SIRS was established.Forty healthy volunteers were enrolled as control.Results Compared with the control，the percentage of CD4+CD25+ Treg was significant higher[（14.21±3.43）% vs（9.53±3.22），P lt;0.01] and the ratio of CD4/CD8 and IS% were significant lower in patients with severe multiple trauma[（5.94±0.66）% vs（6.74±0.95）%，（1.22±0.25）% vs（1.72±0.36）%，respectively，both P lt;0.01].In those patients（n=14） who developed secondary infection，Treg% was significant higher [（18.69±4.21）% vs（12.58±2.49）%，P lt;0.01]，while IS% and CD4/CD8 were significant lower [（5.79±0.68）% vs（6.15±0.57）%，（1.15±0.25）% vs（1.39±0.25）%，both P lt;0.01].compared to the patients without secondary infection Conlusion CD4+CD25+ Treg is valuable to estimate the cellular immunity and predict secondary infection in patients with severe multiple trauma.

Citation： ZHANG Lina ,WU Tiejun,TIAN Hui. The change ofCD4+CD25+ Treg and it’s effect on cell cellular immunity in patients with systemic inflammatory response syndrome due to severe multiple trauma. Chinese Journal of Respiratory and Critical Care Medicine, 2008, 08(5): 338-341. doi: Copy

1.	贾健，金鸿宾，王基.多发伤的特征及其对策探讨.创伤外科杂志，2000，2：23-25.
2.	Dombrovskiy VY，Martin AA，Sunderram J，et al.Rapid increase in hospitalization and mortality rates for severe sepsis in the United States：a trend analysis from 1993 to 2003.Crit Care Med，2007，35：1244-1250.
3.	Ni Choileain N，MacConmara M，Zang Y，et al.Enhanced regulatory T cell activity is an element of the host response to injury.J Immunol，2006，176：225-236.
4.	白涛，主编.现代创伤诊断学.北京：人民军医出版社，1996，455.
5.	Bone RC，Balk RA，Cerra FB，et al.Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis.The ACCP/SCCM Consensus Conference Committee.American College of Chest Physicians/Society of Critical Care Medicine.Chest，1992，101：1644-1655.
6.	Fontenot JD，Gavin MA，Rudensky AY.Foxp3 programs the development and function of CD4+CD25+ regulatory T cells.Nat Immunol，2003，4：330-336.
7.	Iwasaka H，Noguchi T.Th1/Th2 balance in systemic inflammatory response syndrome（SIRS）.Nippon Rinsho，2004，62：2237-2243.
8.	Suvas S，Kumaraguru U，Pack CD，et al.CD4+CD25+ T cells regulate virus-specific primary and memory CD8+ T cell responses.J Exp Med，2003，198：889-901.
9.	林其燧，陈立奇，吴卫，等.外周淋巴细胞脱氧核糖核酸9例核蛋白体转录活性分析.中华医学检验杂志，1996，19：220-222.
10.	Maggi E，Cosmi L，Liotta F，et al.Thymic regulatory T cells.Autoimmun Rev，2005，4：579-586.
11.	Patenaude J，D’Elia M，Hamelin C，et al.Burn injury induces a change in T cell homeostasis affecting preferentially CD4+ T cells.J Leukoc Biol，2005，77：141-150.
12.	Murphy TJ，Ni Choileain N，Zang Y，et al.CD4+CD25+ regulatory T cells control innate immune reactivity after injury.J Immunol，2005，174：2957-2963.
13.	von Boehmer H.Mechanisms of suppression by suppressor T cells.Nat immunol，2005，6：338-344.
14.	Jonuleit H，Schmitt E，Kakirman H，et al.Infectious tolerance：human CD25（+） regulatory T cells convey suppressor activity to conventional CD4（+） T helper cells.J Exp Med，2002，196：255-260.
15.	Goudy KS，Burkhardt BR，Wasserfall C，et al.Systemic Overexpression of IL-10 Induces CD4+CD25+ Cell Populations In Vivo and Ameliorates Type 1 Diabetes in Nonobese Diabetic Mice in a Dose-Dependent Fashion.J Immunol，2003，171：2270-2278.
16.	MacConmara MP，Maung AA，Fujimi S，et al.Increased CD4+ CD25+ T regulatory cell activity in trauma patients depresses protective Th1 immunity.Ann Surg，2006；244：514-523.
17.	Melencio L，McKallip RJ，Guan H，et al.Role of CD4（+）CD25（+） T regulatory cells in IL-2-induced vascular leak.Int Immunol，2006，18：1461-1471.
18.	Heuer JG，Zhang T，Zhao J，et al.Adoptive transfer of in vitro-stimulated CD4+CD25+ regulatory T cells increases bacterial clearance and improves survival in polymicrobial sepsis.J Immunol，2005，174：7141-7146.
19.	Kelly JL，O’Suilleabhain CB，Soberg CC，et al.Severe injury triggers antigen-specific T-helper cell dysfunction.Shock，1999，12：39-45.

1. 贾健，金鸿宾，王基.多发伤的特征及其对策探讨.创伤外科杂志，2000，2：23-25.
2. Dombrovskiy VY，Martin AA，Sunderram J，et al.Rapid increase in hospitalization and mortality rates for severe sepsis in the United States：a trend analysis from 1993 to 2003.Crit Care Med，2007，35：1244-1250.
3. Ni Choileain N，MacConmara M，Zang Y，et al.Enhanced regulatory T cell activity is an element of the host response to injury.J Immunol，2006，176：225-236.
4. 白涛，主编.现代创伤诊断学.北京：人民军医出版社，1996，455.
5. Bone RC，Balk RA，Cerra FB，et al.Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis.The ACCP/SCCM Consensus Conference Committee.American College of Chest Physicians/Society of Critical Care Medicine.Chest，1992，101：1644-1655.
6. Fontenot JD，Gavin MA，Rudensky AY.Foxp3 programs the development and function of CD4+CD25+ regulatory T cells.Nat Immunol，2003，4：330-336.
7. Iwasaka H，Noguchi T.Th1/Th2 balance in systemic inflammatory response syndrome（SIRS）.Nippon Rinsho，2004，62：2237-2243.
8. Suvas S，Kumaraguru U，Pack CD，et al.CD4+CD25+ T cells regulate virus-specific primary and memory CD8+ T cell responses.J Exp Med，2003，198：889-901.
9. 林其燧，陈立奇，吴卫，等.外周淋巴细胞脱氧核糖核酸9例核蛋白体转录活性分析.中华医学检验杂志，1996，19：220-222.
10. Maggi E，Cosmi L，Liotta F，et al.Thymic regulatory T cells.Autoimmun Rev，2005，4：579-586.
11. Patenaude J，D’Elia M，Hamelin C，et al.Burn injury induces a change in T cell homeostasis affecting preferentially CD4+ T cells.J Leukoc Biol，2005，77：141-150.
12. Murphy TJ，Ni Choileain N，Zang Y，et al.CD4+CD25+ regulatory T cells control innate immune reactivity after injury.J Immunol，2005，174：2957-2963.
13. von Boehmer H.Mechanisms of suppression by suppressor T cells.Nat immunol，2005，6：338-344.
14. Jonuleit H，Schmitt E，Kakirman H，et al.Infectious tolerance：human CD25（+） regulatory T cells convey suppressor activity to conventional CD4（+） T helper cells.J Exp Med，2002，196：255-260.
15. Goudy KS，Burkhardt BR，Wasserfall C，et al.Systemic Overexpression of IL-10 Induces CD4+CD25+ Cell Populations In Vivo and Ameliorates Type 1 Diabetes in Nonobese Diabetic Mice in a Dose-Dependent Fashion.J Immunol，2003，171：2270-2278.
16. MacConmara MP，Maung AA，Fujimi S，et al.Increased CD4+ CD25+ T regulatory cell activity in trauma patients depresses protective Th1 immunity.Ann Surg，2006；244：514-523.
17. Melencio L，McKallip RJ，Guan H，et al.Role of CD4（+）CD25（+） T regulatory cells in IL-2-induced vascular leak.Int Immunol，2006，18：1461-1471.
18. Heuer JG，Zhang T，Zhao J，et al.Adoptive transfer of in vitro-stimulated CD4+CD25+ regulatory T cells increases bacterial clearance and improves survival in polymicrobial sepsis.J Immunol，2005，174：7141-7146.
19. Kelly JL，O’Suilleabhain CB，Soberg CC，et al.Severe injury triggers antigen-specific T-helper cell dysfunction.Shock，1999，12：39-45.

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The change ofCD4+CD25+ Treg and it’s effect on cell cellular immunity in patients with systemic inflammatory response syndrome due to severe multiple trauma

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