Compartmental immunophenotyping in COVID-19 ARDS: A case series.
Adult
Aged
CD8-Positive T-Lymphocytes
/ immunology
COVID-19
/ immunology
Cross-Sectional Studies
Cytokines
/ immunology
Female
Humans
Immunophenotyping
Lung
/ immunology
Lymphopenia
/ immunology
Male
Middle Aged
Respiratory Distress Syndrome
/ immunology
SARS-CoV-2
/ immunology
Th17 Cells
/ immunology
Acute respiratory distress syndrome
COVID-19
bronchoalveolar lavage
cytokines
flow cytometry
Journal
The Journal of allergy and clinical immunology
ISSN: 1097-6825
Titre abrégé: J Allergy Clin Immunol
Pays: United States
ID NLM: 1275002
Informations de publication
Date de publication:
01 2021
01 2021
Historique:
received:
17
06
2020
revised:
27
08
2020
accepted:
03
09
2020
pubmed:
27
9
2020
medline:
16
1
2021
entrez:
26
9
2020
Statut:
ppublish
Résumé
Severe immunopathology may drive the deleterious manifestations that are observed in the advanced stages of coronavirus disease 2019 (COVID-19) but are poorly understood. Our aim was to phenotype leukocyte subpopulations and the cytokine milieu in the lungs and blood of critically ill patients with COVID-19 acute respiratory distress syndrome (ARDS). We consecutively included patients less than 72 hours after intubation following informed consent from their next of kin. Bronchoalveolar lavage fluid was evaluated by microscopy; bronchoalveolar lavage fluid and blood were assessed by 10-color flow cytometry and a multiplex cytokine panel. Four mechanically ventilated patients (aged 40-75 years) with moderate-to-severe COVID-19 ARDS were included. Immature neutrophils dominated in both blood and lungs, whereas CD4 and CD8 T-cell lymphopenia was observed in the 2 compartments. However, regulatory T cells and T COVID-19 ARDS exhibits a distinct immunologic profile in the lungs, with a depleted and exhausted CD4 and CD8 T-cell population that resides within a heavily hyperinflammatory milieu.
Sections du résumé
BACKGROUND
Severe immunopathology may drive the deleterious manifestations that are observed in the advanced stages of coronavirus disease 2019 (COVID-19) but are poorly understood.
OBJECTIVE
Our aim was to phenotype leukocyte subpopulations and the cytokine milieu in the lungs and blood of critically ill patients with COVID-19 acute respiratory distress syndrome (ARDS).
METHODS
We consecutively included patients less than 72 hours after intubation following informed consent from their next of kin. Bronchoalveolar lavage fluid was evaluated by microscopy; bronchoalveolar lavage fluid and blood were assessed by 10-color flow cytometry and a multiplex cytokine panel.
RESULTS
Four mechanically ventilated patients (aged 40-75 years) with moderate-to-severe COVID-19 ARDS were included. Immature neutrophils dominated in both blood and lungs, whereas CD4 and CD8 T-cell lymphopenia was observed in the 2 compartments. However, regulatory T cells and T
CONCLUSION
COVID-19 ARDS exhibits a distinct immunologic profile in the lungs, with a depleted and exhausted CD4 and CD8 T-cell population that resides within a heavily hyperinflammatory milieu.
Identifiants
pubmed: 32979342
pii: S0091-6749(20)31317-8
doi: 10.1016/j.jaci.2020.09.009
pmc: PMC7581505
pii:
doi:
Substances chimiques
Cytokines
0
Types de publication
Clinical Trial
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
81-91Informations de copyright
Copyright © 2020 The Authors. Published by Elsevier Inc. All rights reserved.
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