Characteristics of peripheral lymphocyte subsets and antibodies in COVID-19-infected kidney transplantation recipients.

IF 4.8 2区 医学 Q2 IMMUNOLOGY
International immunopharmacology Pub Date : 2025-01-03 Epub Date: 2024-12-12 DOI:10.1016/j.intimp.2024.113755
Honghui Long, Yunze Tai, Jiwen Fan, Xiaoqi Ou, Lin Yan, Yu Fan, Weihua Feng, Jie Chen, Yi Li
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引用次数: 0

Abstract

Background: Peripheral lymphocyte subsets play vital roles in various disease conditions. However, the roles of kidney transplant recipients (KTRs) with novel coronavirus pneumonia (COVID-19) are still unclear. In this research, we investigated the predictive value of peripheral blood lymphocyte subsets on the severity of KTRs with COVID-19 and the correlation between antibodies and lymphocyte levels.

Methods: 84 patients with kidney transplantation combined with COVID-19 admitted from December 2022 to February 2023 were included. On the basis of the severity of COVID-19, they were categorized into a mild (n = 49) and a severe group (n = 35). The logistic regression method was utilized to build the critical risk prediction model for KTRs complicated with COVID-19. The receiver operator characteristic curve (ROC), calibration plot and clinical decision curve analysis (DCA) were applied to assess the discrimination, calibration and clinical application value of this model. The Spearman correlation test was applied to examine the connection between antibodies and various immune indexes.

Results: Except for the increase of CD4+HLA-DR+ T cells, the number of CD3+, CD4+, and CD8+ T cell subsets in severe was lower than that in mild (P < 0.05). IL-6 in severe was higher than mild (P < 0.05). After screening variables, we established a regression equation prediction model, logit (P) = 4.965+ (-0.038) × (CD3+/lymphocytes (%)) + 0.064× (CD4+HLA-DR+/ CD4+ T cells (%)) + (-0.040) × (CD14+HLA-DR+/monocytes (%)). The area under the ROC curve (AUC) of the prediction model was 0.779 (95 % CI 0.679-0.879, P = 0.001). The cut-off value was 0.308, with a prediction sensitivity of 0.829 (95 % CI 0.657-0.928) and a specificity of 0.653 (95 % CI 0.503-0.779). Logistic regression analysis showed the increase in the percentage of CD4+HLA-DR+ T cells among CD4+ T cells was a risk factor for COVID-19 severity among kidney transplant recipients, while the increase in the percentage of CD3+ T cells among lymphocytes and CD14+HLA-DR+ monocytes among CD14+ monocytes acted as protective factors. COVID-19 antibodies were negatively correlated with CD8+CD45RA+CD27- (Terminally Differentiated Effector Memory T Cells, TEMRA), CD8+CD28-, CD8+CD38+ and CD4+CD38+ T cells, while positively correlated with CD8+CD45RA-CD27- (Effector Memory T cells, T8EM), CD8+CD45RA-CD27+ (Central Memory T cells, T8CM) and CD8+CD28+ T cells.

Conclusion: A predictive model was developed and validated for predicting the severe form of COVID-19 in KTRs. The model showed good predictive ability, concordance, and potential clinical utility.

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来源期刊
CiteScore
8.40
自引率
3.60%
发文量
935
审稿时长
53 days
期刊介绍: International Immunopharmacology is the primary vehicle for the publication of original research papers pertinent to the overlapping areas of immunology, pharmacology, cytokine biology, immunotherapy, immunopathology and immunotoxicology. Review articles that encompass these subjects are also welcome. The subject material appropriate for submission includes: • Clinical studies employing immunotherapy of any type including the use of: bacterial and chemical agents; thymic hormones, interferon, lymphokines, etc., in transplantation and diseases such as cancer, immunodeficiency, chronic infection and allergic, inflammatory or autoimmune disorders. • Studies on the mechanisms of action of these agents for specific parameters of immune competence as well as the overall clinical state. • Pre-clinical animal studies and in vitro studies on mechanisms of action with immunopotentiators, immunomodulators, immunoadjuvants and other pharmacological agents active on cells participating in immune or allergic responses. • Pharmacological compounds, microbial products and toxicological agents that affect the lymphoid system, and their mechanisms of action. • Agents that activate genes or modify transcription and translation within the immune response. • Substances activated, generated, or released through immunologic or related pathways that are pharmacologically active. • Production, function and regulation of cytokines and their receptors. • Classical pharmacological studies on the effects of chemokines and bioactive factors released during immunological reactions.
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