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Background though considered to have characteristics of systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) theoretically, Rhupus Syndrome (RS) owns its unique clinical features. In this retrospective cross-sectional study, we included 41 newly diagnosed Rhupus syndrome patients (NRSP). 160 new-diagnosed systemic lupus erythematosus patients (NSLEP) and 709 new-diagnosed rheumatoid arthritis patients (NRAP) were admitted as positive control groups. The clinical, serological, and radiological features among groups were compared, the disease activity of RA and SLE was evaluated, and the proportion of lymphocyte subsets in NRSPs under similar disease activity levels was explored. The initial onset age of RS patients was significantly younger than RA patients (P = 0.032), older than SLE patients (P = 0.008). 19.5% (8/41) RS patients initially presented with SLE symptom, while 12.2% RS patients presented with symptoms of both diseases. Hematopoietic dysfunction was the most prominent systemic manifestation in RS (61.0%, 25/41), only 9.8% patients experienced renal damage, and neurological disease were even rarer. Moreover, RS exhibited immunological characteristics different from NRAPs and NSLEPs, mainly manifested in decreased CD4+ T cell and NK cell counts, increased ratio of CD8 + T (%) and total B cells, and decreased ratio of NK cells. RS is characterized by a higher incidence of interstitial lung disease and significant hyperglobulinemia besides the typical clinical characteristics of RA and SLE, which may be associated with a re-imbalanced lymphocyte subset. Evaluation of disease activity of RS cannot only rely on either SLEDAI-2 K or DAS28-ESR/-CRP, but more comprehensive assessment tools. [ABSTRACT FROM AUTHOR]

Objective To explore the correlation between circulating lymphocyte profiles and the outcomes of non-small cell lung cancer (NSCLC) patients undergoing epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) therapy. Methods A retrospective cohort of 40 patients who received EGFR-TKI therapy at Peking Union Medical College Hospital was designed. Circulating lymphocyte subsets were collected using flow cytometry for dynamic monitoring during EGFR-TKI therapy. The survival of each patient was followed up by telephone call. The correlation of baseline and dynamic change of the peripheral blood circulating lymphocyte subsets and survival were further analyzed. Results Patients who responded to EGFR-TKI therapy had significantly higher baseline circulating CD4+CD45RA+CD62L+ T-cell counts during dynamic monitoring. The median progression-free survival (PFS) for the entire population was 27.1 months; however, overall survival (OS) was not achieved. The median PFS did not differ significantly between patients with higher and lower baseline CD4+CD45RA+CD62L+ T-cell counts. Furthermore, dynamic changes in CD4+CD45RA+CD62L+ T-cell counts were significantly correlated with not only the response to EGFR-TKI therapy response, but also PFS. PFS of patients with stable or increased CD4+CD45RA+CD62L+ T-cell counts during the EGFR-TKI therapy was significantly longer than that of patients with decreased CD4+CD45RA+CD62L+ T-cell counts (29.1 months vs. 9.4 months; P＜0.001). Conclusions Higher baseline circulating CD4+CD45RA+CD62L+ T-cell counts indicate a better EGFR-TKI response, and dynamic changes in CD4+CD45RA+CD62L+ T-cell counts are associated with prolonged PFS.

Copyright of Basic & Clinical Medicine is the property of Editorial Office of Basic & Clinical Medicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives: For children with Kawasaki disease (KD) at high risk of developing coronary artery lesions and requiring retreatment with intravenous immunoglobulin (IVIG), the availability of accurate prediction models remains limited because of inconsistent variables and unsatisfactory prediction results. We aimed to construct models to predict patient's probability of IVIG retreatment combining children's individual inflammatory characteristics. Methods: Clinical manifestations and laboratory examinations of 266 children with KD were retrospectively analysed to build a development cohort data set (DC) and a validation cohort data set (VC). In the DC, binary logistic regression analyses were performed using R language. Nomograms and receiver operating curves were plotted. The concordance index (C index), net reclassification index, integrated discrimination improvement index and confusion matrix were applied to evaluate and validate the models. Results: Models_5V and _9V were established. Both contained variables including the percentages of CD8+ T cells, CD4+ T cells, CD3+ T cells, levels of interleukin (IL)‐2R and CRP. Model_9V additionally included variables for IL‐6, TNF‐α, NT‐proBNP and sex, with a C index of 0.86 (95% CI 0.79–0.92). When model_9V was compared with model_5V, the NRI and IDI were 0.15 (95% CI 0.01–0.30, P < 0.01) and 0.07 (95% CI 0.02–0.12, P < 0.01). In the VC, the sensitivity, specificity and precision of model_9V were 1, 0.875 and 0.667, while those of model_5V were 0.833, 0.875 and 0.625. Conclusion: Model_9V combined cytokine profiles and lymphocyte subsets with clinical characteristics and was superior to model_5V achieving satisfactory predictive power and providing a novel strategy early to identify patients who needed IVIG retreatment. [ABSTRACT FROM AUTHOR]

Objective To explore the distribution of T lymphocyte subsets in peripheral blood of healthy adults from Chashan Town of Dongguan in Guangdong Province. Methods The venous whole blood samples were collected from 827 healthy adults. The percentage of CD3+ T cells， CD4+ T cells， CD8+ T cells， CD4+CD8+ double positive （DP） T cells， and regulatory T（Treg） cells and CD4+/CD8+ ratio were determined by flow cytometry. Results The percentage of CD3+ T cells， CD4+ T cells， CD8+ T cells， CD4+/CD8+ ratio， DP T cells and Treg cells were determined as 40.5%-75.2%， 35.4%-68.9%， 27.4%-61.8%， 0.6-2.4， 0.2%-2.7% and 2.4%-6.0%， respectively. Significant differences were observed in the distribution of lymphocyte subsets regarding age and gender （all P < 0.05）. Conclusion The distribution of T lymphocyte subsets in healthy adults from Chashan Town of Dongguan in Guangdong Province was successfully analyzed， providing valuable reference for clinicians in this region.

Abstract Background Clinical manifestations of Epstein–Barr virus (EBV) infection are diverse. This study aimed to explore the immune response in EBV-related diseases and the correlation between immune cells and adenosine deaminase (ADA) levels. Methods This study was conducted at the Children’s Hospital of Soochow University. In total, 104 patients with EBV-associated respiratory tract infection (EBV-RTI), 32 patients with atypical EBV infection, 54 patients with EBV-associated infectious mononucleosis (IM1, with normal alanine aminotransferase [ALT] levels), 50 patients with EBV-IM2 (with elevated ALT levels), 50 patients with acute respiratory infection (AURI, with other pathogens), and 30 healthy controls were enrolled in this study. Indicators of ADA, immunoglobulins (Igs), and lymphocyte subsets were analyzed for EBV-related diseases. Results Differences in the white blood cell, lymphocyte counts, ADA levels, IgA, IgG and IgM titers, percentage of CD3+, CD3+CD4+, CD3+CD8+, CD16+CD56+, CD3−CD19+, and CD19+CD23+ lymphocytes, and CD4+/CD8+ ratio between EBV-related disease groups were all statistically significant (P

Heba Ahmed Osman,1 Hanaa Nafady-Hego,2 Khalid Ali Nasif,3,4 Heba A Ahmed,5 Ekram Abdel-Rahman Mahmoud,6 Noher Mohamad Abass,7 Amal Rayan,8 Marwa Ahmed Mahmoud,9 Asmaa Nafady10 1Department of Tropical Medicine and Gastroenterology, Qena Faculty of Medicine, South Valley University, Qena, Egypt; 2Department of Microbiology and Immunology, Faculty of Medicine, Assiut University, Assiut, Egypt; 3Department of Clinical Biochemistry, College of Medicine, King Khalid University, Abha, Kingdom of Saudi Arabia; 4Department of Biochemistry, Faculty of Medicine, Minia University, Minia, Egypt; 5Department of Clinical and Chemical Pathology Sohag Faculty of Medicine Sohag University, Sohag, Egypt; 6Department of Medical Microbiology & Immunology, Faculty of Medicine, Sohag University, Sohag, Egypt; 7Department of Internal Medicine, Faculty of Medicine, Sohag University, Sohag, Egypt; 8Department of Clinical Oncology, Faculty of Medicine, Assiut University, Assiut, Egypt; 9Department of Medical Physiology, Faculty of Medicine, Sohag University, Sohag, Egypt; 10Department of Clinical and Chemical Pathology, Qena Faculty of Medicine, South Valley University, Qena, EgyptCorrespondence: Heba Ahmed Osman, Tropical Medicine and Gastroenterology, Qena Faculty of Medicine, South Valley University, Qena, Egypt, Email drheba.saleh@med.svu.edu.eg; hebaahmed198098@yahoo.comIntroduction: HCC is frequently diagnosed late, when only palliative treatment is available. So, we try to use different immunological markers to identify early HCC in patients with unremarkable raised AFP.Methods: This study was conducted on 112 participants divided into two equal groups: Group I, 56 patients with liver cirrhosis and different stages of HCC; Group II, 56 patients with liver cirrhosis. The diagnosis of HCC was based on AASLD guidelines. TNM and BCLC classification systems are used for staging of HCC.Results: A significant reduction in the median percentage of lymphocyte subset (CD3+, CD4+, CD8+, CD19+) and NK cell percentage (CD56+) has been detected in HCC patients (all P < 0.001). In the HCC group the median monocyte subpopulations CD14+ CD16− Classical, CD14++ CD16+ Intermediate, and CD14−+ CD16++ Non-Classical were 11.7, 4.0, and 3.5, respectively, with marked reduction compared with liver cirrhosis group (all P < 0.001). Patients with advanced stages (BCLC C and D) were more likely to have significantly higher median CD33+ than patients with early stages (BCLC A and B) (P = 0.05); also, the median levels of HLA DR+ lymphocytes % in the HCC case group were 21.8 in patients with advanced disease (BCLC C and D) and 13.1 in patients with early stages of the disease (P = 0.04). Patients with late stage (TNM III) were more likely to have significantly higher median CD14+ CD16− Classical monocyte subset, CD36+ HLA DR+, and CD36+ CD16− than patients with early stages (TNM I and II).Conclusion: Patients with HCC with unremarkable raised AFP showed marked reduction in lymphocytes, natural killer cells, and all monocyte subpopulations. In addition, patients with advanced HCC showed increased CD33+ and HLA DR+ lymphocytes %, CD14+ CD16− Classical monocyte subset, CD36+ HLA DR+, and CD36+ CD16− compared with patients with early stages of HCC.Keywords: monocyte subpopulation, lymphocyte subset, hepatocellular carcinoma, Barcelona clinic liver cancer, tumor (T), nodes (N), metastases (M)

Abstract Background In chronic lymphocytic leukemia (CLL), changes in the peripheral blood lymphocyte subsets play an important role in disease progression and infectious complications. The impact of chemoimmunotherapy (CIT) on these changes has not been extensively studied Methods We used multi‐color flow cytometry, to prospectively measure absolute and relative numbers of CD4+ and CD8+ T‐cells and their subsets in 45 patients with indolent untreated CLL, 86 patients indicated for first‐line treatment, and 34 healthy controls. In 55 patients, we analyzed the impact of CIT Results CLL patients had a significant increase in most cell populations in comparison to controls. Progression of CLL was characterized by significantly elevated counts with the exception of a lower percentage of naïve T‐cells. After treatment, the percentage of naïve T‐cells further decreased at the expense of effector memory T‐cells (TEM). In patients with indolent CLL, higher percentages of naïve CD4+ (p = 0.0026) and naïve CD8+ (p = 0.023) T‐cells were associated with a longer time to first treatment (TTFT). The elevation of CD4+ central memory T‐cells (TCM) (p = 0.27) and TEM (p = 0.003) counts and a higher percentage of CD4+ TEM (p = 0.0047), were linked with shorter TTFT. In treated patients, increased regulatory T‐cells count was associated with shorter time to next treatment (TTNT) (p = 0.042), while higher CD4+ TCM count with shorter TTNT (p = 0.035) and shorter overall survival (p = 0.041). Conclusion Our results indicate that naïve cell depletion and CD4+ TCM and TEM increases are detrimental to CLL patients' prognosis.

Abstract Background Nephrotic syndrome (NS) in children is widely believed to be associated with severe changes in the immune system. Based on lymphocyte subset analysis, we examined the pathogenesis of immune deficiencies in children with NS with varying steroid sensitivity. Methods Our study utilized flow cytometry to retrospectively analyze the ratios of lymphocyte subsets in 204 children with nephrotic syndrome and 19 healthy children. Results Compared with healthy children, the ratio of CD4 + /CD8 + in onset and remission was decreased in SRNS group (p

Introduction Idiopathic aplastic anaemia (IAA) is a heterogeneous autoimmune disease characterised by pancytopenia and bone marrow failure. The objective of the study was to investigate the clusters of lymphocyte subset in newly diagnosed IAA patients and explore their correlation with clinical characteristics.Methods A total of 124 newly diagnosed IAA patients were enrolled. Lymphocyte subset was detected by flow cytometry. Cluster analysis was conducted to identify subgroups of patients based on lymphocyte subset.Results Cluster analysis classified patients into four distinctive subgroups: Cluster 1 (CD4+ T cells dominant), Cluster 2 (CD8+ T cells dominant), Cluster 3 (NK cells dominant) and Cluster 4 (B cells dominant). Patients in Clusters 1 and 4 suffered more severe disease status than ones in Clusters 2 and 3 (p = .013). And with it, patients in Cluster 2 had the highest white blood cell count, haemoglobin level, reticulocyte count and reticulocyte percentage, while patients in Cluster 3 had the lowest lymphocyte percentage and the highest neutrophil count (all p

Objective: The current study aims to investigate the correlation between baseline peripheral blood biomarkers and outcomes in patients with non ⁃ small cell lung cancer (NSCLC) receiving immune checkpoint inhibitors (ICIs) . Methods: A retrospective analysis was conducted of 84 patients with stage Ⅲ or Ⅳ NSCLC, who received PD ⁃ 1 inhibitors combined with chemotherapy as first⁃line treatment in the First Affiliated Hospital of Nanjing Medical University betwee January 2020 and September 2022. The efficacy was evaluated according to RECIST1.1 criteria and the patients were followed up of progression⁃free survival (PFS) . COX regression models were used in the univariate and multivariate survival analysis to assess prognostic effect of baseline peripheral blood parameters before treatments. Kaplan⁃Meier method as used for survival analysis. Log⁃rank tests were used to analyze the survival rates between groups. Results: The median follow⁃up time was 9.93 (5.68~15.38) months, and the median progression⁃free survival (mPFS) was 9.42 (5.63~12.88) months. COX univariate regression analysis and Kaplan⁃Meier survival curves showed that PD⁃ L1 was an independent predictor of immune efficacy (HR=0.299, P=0.003), patients with a high monocyte percentage (≥8.15%) had a better PFS than those with low monocyte percentage (HR=0.313, 95% CI: 0.137~0.711, P=0.006, mPFS 14.37 months vs. 7.60 months) . Patients with a high eosinophil percentage (≥1.90%) also had a better PFS than those with low eosinophil percentage (HR= 0.296, 95%CI: 0.092~0.958, P=0.042, mPFS 13.87 months vs. 7.93 months) . COX multivariate regression analysis showed that both high monocyte percentage and high monocyte percentage parameters were independently associated with better PFS. However, peripheral blood lymphocyte subsets and inflammatory parameters had no predictive role for ICI efficacy. Conclusion: For patients with NSCLC, the percentage of monocytes and eosinophils may be useful predictive markers of response to chemotherapy combined with immunotherapy as first⁃line therapy, and higher percentages of moncytes and eosinophils were associated with longer progression⁃ free survival time. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Chinese Institute of Food Science & Technology / Zhongguo Shipin Xuebao is the property of Journal of Chinese Institute of Food Science & Technology Periodical Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Lymphocytes play crucial roles in tumor surveillance in diffuse large B-cell lymphoma (DLBCL). Neutrophil-to-lymphocyte ratio (NLR), a biomarker for systematic inflammation, has been confirmed to be a prognostic factor for many malignant diseases. Herein, we conducted a systemic in-depth study of circulating neutrophils and lymphocyte subsets in DLBCL patients and their dynamics along with chemoimmunotherapy. A total of 61 patients with DLBCL were enrolled. Detection of lymphocyte subsets by flow cytometry was conducted at diagnosis and after 2/4/6/8 cycles' treatment of R-CHOP. Clinical significance, including incidence of infection, curative effect and disease-free survival (DFS), was analyzed based on the patients' clinical data and the quantity of lymphocyte subsets. The absolute numbers of neutrophils in stage III-IV DLBCL patients were obviously increased (p = 0.012), while the absolute numbers of lymphocytes were decreased (p = 0.025). Consequently, DLBCL patients had significantly higher NLR than healthy controls (p < 0.001). Further analysis of lymphocyte subsets showed a significantly reduced CD4 + T cells in DLBCL patients (p = 0.001). Patients with a lower lymphocyte counts (< 1.26*10E9/L) were more susceptible to infection (p < 0.001). NK cells were much higher in patients achieving complete remission than those of non-complete remission (p = 0.032). Higher neutrophils and NLR were closely associated with poorer DFS (p = 0.001 and p = 0.045, respectively). Circulating cells in DLBCL patients were dysregulated, featured with increased neutrophils and reduced lymphocytes. Higher NK cells before treatment predicted better therapeutic outcome. Higher neutrophils and NLR can be regarded as inferior prognostic predictors for DLBCL patients at diagnosis. [ABSTRACT FROM AUTHOR]

Copyright of Journal of New Medicine is the property of Sun Yat Sen University and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To explore changes in the percentage and cell absolute count of lymphocyte subsets in peripheral blood of patients with novel coronavirus pneumonia (COVID-19). Methods: The clinical data of 244 patients with COVID-19 admitted to the Ninth People′s Hospital, Shanghai Jiao Tong University School of Medicine from April 25 to May 16, 2022 were retrospectively analyzed and classified into difterent groups according to the types of diseases (mild, ordinary and severe), vaccination status and co-existing underlying diseases. Flow cytometry was used to detect the absolute counts and percentages of different lymphocyte subsets(CD3+T lymphocytes, CD3+CD4+T lymphocytes, CD3+CD8+T lymphocytes, CD16+CD56+NK cells and CD19+B lymphocytes) in each group. Further, we analyzed the relationship between the changes in peripheral blood lymphocyte subsets and the above clinical characteristics in patients. Results: Compared with those in the mild group, the absolute count of each lymphocyte subsets (P

Background: Clinical manifestations of Epstein–Barr virus (EBV) infection are diverse. This study aimed to explore the immune response in EBV-related diseases and the correlation between immune cells and adenosine deaminase (ADA) levels. Methods: This study was conducted at the Children's Hospital of Soochow University. In total, 104 patients with EBV-associated respiratory tract infection (EBV-RTI), 32 patients with atypical EBV infection, 54 patients with EBV-associated infectious mononucleosis (IM1, with normal alanine aminotransferase [ALT] levels), 50 patients with EBV-IM2 (with elevated ALT levels), 50 patients with acute respiratory infection (AURI, with other pathogens), and 30 healthy controls were enrolled in this study. Indicators of ADA, immunoglobulins (Igs), and lymphocyte subsets were analyzed for EBV-related diseases. Results: Differences in the white blood cell, lymphocyte counts, ADA levels, IgA, IgG and IgM titers, percentage of CD3+, CD3+CD4+, CD3+CD8+, CD16+CD56+, CD3−CD19+, and CD19+CD23+ lymphocytes, and CD4+/CD8+ ratio between EBV-related disease groups were all statistically significant (P < 0.01). ADA levels in the EBV-related disease groups were significantly higher than those in the control group (P < 0.01). The lymphocyte count, ADA levels, IgA and IgG titers, and percentage of CD3+ and CD3+CD8 + lymphocytes in the atypical EBV infection, EBV-IM1, and EBV-IM2 groups were significantly higher than those in the EBV-RTI, AUTI, and control groups (P < 0.01), whereas the percentage of CD3+CD4+, CD3−CD19+, and CD19+CD23+ lymphocytes and CD4+/CD8+ ratio showed the opposite trend. ADA levels were consistent with and closely related to the viral load and cellular and humoral immunity in EBV-related diseases. Conclusions: ADA levels, humoral immunity, and cellular immunity were diverse in EBV-related diseases, and ADA was closely related to Igs and lymphocyte subsets. [ABSTRACT FROM AUTHOR]

Background: In chronic lymphocytic leukemia (CLL), changes in the peripheral blood lymphocyte subsets play an important role in disease progression and infectious complications. The impact of chemoimmunotherapy (CIT) on these changes has not been extensively studied Methods: We used multi‐color flow cytometry, to prospectively measure absolute and relative numbers of CD4+ and CD8+ T‐cells and their subsets in 45 patients with indolent untreated CLL, 86 patients indicated for first‐line treatment, and 34 healthy controls. In 55 patients, we analyzed the impact of CIT Results: CLL patients had a significant increase in most cell populations in comparison to controls. Progression of CLL was characterized by significantly elevated counts with the exception of a lower percentage of naïve T‐cells. After treatment, the percentage of naïve T‐cells further decreased at the expense of effector memory T‐cells (TEM). In patients with indolent CLL, higher percentages of naïve CD4+ (p = 0.0026) and naïve CD8+ (p = 0.023) T‐cells were associated with a longer time to first treatment (TTFT). The elevation of CD4+ central memory T‐cells (TCM) (p = 0.27) and TEM (p = 0.003) counts and a higher percentage of CD4+ TEM (p = 0.0047), were linked with shorter TTFT. In treated patients, increased regulatory T‐cells count was associated with shorter time to next treatment (TTNT) (p = 0.042), while higher CD4+ TCM count with shorter TTNT (p = 0.035) and shorter overall survival (p = 0.041). Conclusion: Our results indicate that naïve cell depletion and CD4+ TCM and TEM increases are detrimental to CLL patients' prognosis. [ABSTRACT FROM AUTHOR]

Background: Nephrotic syndrome (NS) in children is widely believed to be associated with severe changes in the immune system. Based on lymphocyte subset analysis, we examined the pathogenesis of immune deficiencies in children with NS with varying steroid sensitivity. Methods: Our study utilized flow cytometry to retrospectively analyze the ratios of lymphocyte subsets in 204 children with nephrotic syndrome and 19 healthy children. Results: Compared with healthy children, the ratio of CD4 + /CD8 + in onset and remission was decreased in SRNS group (p < 0.05), and CD19 + B lymphocytes were increased in onset (p < 0.05). Compared with onset, the proportion of CD19 + B lymphocytes decreased in SRNS, while the proportion of CD19 + B lymphocytes increased in SDNS, p < (0.01). The ratio of CD8 + T/CD19 + B in onset in SDNS group was significantly higher than that in SSNS and SRNS groups (p < 0.01) and healthy control group (p < 0.05). Compared with onset, the ratio of CD8 + T/CD19 + B in SDNS group decreased significantly (p < 0.01), while the ratio of CD8 + T/CD19 + B in SRNS group increased significantly (p < 0.01). The proportion of CD56 + CD16 + NK cells was significantly reduced in children with INS (p < 0.01). Conclusion: CD8 + T lymphocytes may be involved in the mechanism of lymphocyte subsets disorder during onset of SDNS, while CD19 + B lymphocytes may be involved in the mechanism of lymphocyte subsets disorder during relapse of SDNS. The CD8 + T/CD19 + B ratio may predict the degree of frequent recurrence. There is a certain degree of lymphoid subsets disorder in children with NS. [ABSTRACT FROM AUTHOR]

Background: (COVID-19) pathophysiology and the predictive factors are not fully understood, but lymphocyte dysregulation appears to play a role. Aim and Objectives: To explore the clinical value of lymphocyte subset changes in COVID-19 patients' peripheral blood, which may illustrate the pathogenesis of COVID-19. Methods: This is prospective cohort study of 73 hospitalized patients with confirmed COVID-19 who were classified into two groups: non-severe and severe. Lymphocyte subsets (CD3, CD4, CD8, CD19, and CD56) were assessed using flow cytometry. Results Lymphocyte gate, CD3, CD4, CD8, and CD56 counts were significantly reduced in severe cases compared with nonsevere cases (P0.001, 0.006, 0.016, 0.011, and 0.008 respectively). Patients were divided into two groups according to cut off age (<50 and = 50years) and (NLR) (NLR <4.14 and NLR = 4.14). There was a significant difference in severe illness probability in two groups P0.001 and 0.001 respectively). Then, patients were divided into four groups by both NLR cutoff and age, There also significant difference in severe illness probability between four groups (P<0.001). Conclusion Based on our data, management of patients with COVID-19 pneumonia can be improved based on NLR and age model. We suggest that patients with NLR = 4.14 should be admitted to isolation ward with close follow-up and actively transfer to intensive care unit. [ABSTRACT FROM AUTHOR]

Although cladribine induces sustained reductions in peripheral T and B lymphocytes, little is known about its effect on axonal damage reduction in multiple sclerosis (MS), which could be demonstrated by assessing the serum neurofilament light chain (sNfL) levels. We investigated the reduction/reconstitution of different lymphocyte subsets (LS) by verifying the correlation with no evidence of disease activity (NEDA) and the variation in sNfL levels during cladribine treatment. We analysed 33 highly active relapsing MS patients and followed them up for 12 ± 3.3 months; blood samples were collected at treatment start (W0) and after 8, 24 and 48 weeks. Seventeen patients (60.7%) showed NEDA during the first treatment. At week 8, we observed a significant decrease in B memory cells, B regulatory 1 CD19+/CD38+ and B regulatory 2 CD19+/CD25+, a significant increase in T regulatory CD4+/CD25+, a slight increase in T cytotoxic CD3+/CD8+ and a non-significant decrease in T helper CD3+/CD4+. Starting from week 24, the B subsets recovered; however, at week 48, CD19+/CD38+ and CD19+/CD25+ reached values near the baseline, while the Bmem were significantly lower. The T cell subsets remained unchanged except for CD4+/CD25+, which increased compared to W0. The LS changes were not predictive of NEDA achievement. The sNfL levels were significantly lower at week 24 (p = 0.046) vs. baseline. These results could demonstrate how cladribine, by inflammatory activity depletion, can also reduce axonal damage, according to the sNfL levels. [ABSTRACT FROM AUTHOR]

Idiopathic aplastic anaemia (IAA) is a heterogeneous autoimmune disease characterised by pancytopenia and bone marrow failure. The objective of the study was to investigate the clusters of lymphocyte subset in newly diagnosed IAA patients and explore their correlation with clinical characteristics. A total of 124 newly diagnosed IAA patients were enrolled. Lymphocyte subset was detected by flow cytometry. Cluster analysis was conducted to identify subgroups of patients based on lymphocyte subset. Cluster analysis classified patients into four distinctive subgroups: Cluster 1 (CD4+ T cells dominant), Cluster 2 (CD8+ T cells dominant), Cluster 3 (NK cells dominant) and Cluster 4 (B cells dominant). Patients in Clusters 1 and 4 suffered more severe disease status than ones in Clusters 2 and 3 (p =.013). And with it, patients in Cluster 2 had the highest white blood cell count, haemoglobin level, reticulocyte count and reticulocyte percentage, while patients in Cluster 3 had the lowest lymphocyte percentage and the highest neutrophil count (all p <.05). Unexpectedly, patients in Cluster 3 tended to have superior curative effect than ones in other clusters, an ordinal logistic regression analysis further confirmed the independent correlation between Cluster 3 and good response to treatment. Lymphocyte subset clustering may serve as a biomarker for assessing disease severity and treatment efficacy in newly diagnosed IAA patients. Newly diagnosed IAA patients could be classified into 4 distinctive subgroups with similar immune patterns by using cluster analysis of lymphocyte subset. Clusters of lymphocyte subset were closely correlated with disease severity and treatment response of IAA. Lymphocyte subset clustering may serve as a promising tool for assessing disease severity and treatment efficacy in newly diagnosed IAA patients. [ABSTRACT FROM AUTHOR]

Background and Aims: To estimate the biological variation (BV) for lymphocyte subset counts in healthy adults based on full-spectrum flow cytometry (FS-FCM) and the most commonly used BD Multitest TM 6-Color TBNK kit in China., Materials and Methods: The study was designed according to the BV Data Critical Appraisal Checklist (BIVAC). Peripheral blood samples were collected from 60 healthy adults every two weeks for a period of 20 weeks (10 samples from each subject). Lymphocyte subsets were quantified using FS-FCM and the kit mentioned above. Bayesian models were used to analyze within-subject BV (CV I ) and between-subject BV (CV G ). Accordingly, the analytical performance specifications (APS) and more were derived. Additionally, the allowable total error (TEa) derived from the BV data in this study was compared with that based on state-of-the-art (SOTA)., Results: The CV I s for the percentages of CD3 + , CD3 + CD4 + , CD3 + CD8 + , CD3 - CD19 + , and CD3 - CD16/CD56 + cells were 3.60 %, 7.05 %, 4.19 %, 10.73 %, and 19.17 %, respectively. The CV I s for the absolute counts were 13.99 %, 13.51 %, 16.19 %, 16.30 %, and 28.64 %, respectively. The CV G s for the percentages were 11.78 %, 21.33 %, 35.20 %, 33.69 %, and 44.36 %, and those for the absolute counts were 30.27 %, 28.84 %, 43.11 %, 46.69 %, and 49.21 %, respectively. No significant differences were observed in the CV I and CV G of males and females. The maximum allowable imprecision parameter based on the BV model was absolute CD3 - CD16/56 + cell counts (14.3 %). For most lymphocyte subset parameters, TEa based on SOTA in China was less than the optimal TEa obtained from the BV data of this study., Conclusions: To the best of our knowledge, this study is the first to estimate the BV of lymphocyte subset counts based on FS-FCM and the clinically commonly used BD Multitest TM 6-Color TBNK kit., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2025. Published by Elsevier B.V.)

Objective To investigate the guiding role of quantitative evaluation system of immune status in the individualized management of immunosuppressants for the recipients after liver transplantation. Methods Clinical data of 239 liver transplant recipients were retrospectively analyzed. MingDao Immune Cell Analysis (MICA) was established. All recipients were divided into two groups according to the adjustment regimens of immunosuppressants. The immunosuppressant regimen was adjusted according to MingDao Immune System Score (MISS) in the MISS group (n=84), and the medication plan was empirically adjusted during the same period in the control group (n=155). According to the time of postoperative detection (t), the recipients in the MISS group were divided into subgroup A (t ≤ 28 d, n=78), subgroup B (28 d< t ≤ 6 months, n=68), subgroup C (6 months < t ≤ 12 months, n=18), subgroup D (12 months < t ≤ 24 months, n=18) and subgroup E (t >24 months, n=19). In the MISS group, postoperative MISS scores of recipients in subgroups A-E were analyzed. The incidence of acute rejection and opportunistic infection and the overall survival rate were statistically compared between the MISS and control groups. Results The MISS scores in subgroups A-E were -7.0 (-13.2, -2.0), -2.0 (-5.8, 1.8), -0.5 (-7.3, 2.8), -2.0 (-4.5, 3.3) and -3.0 (-6.0, 1.0), respectively. The immune status of the recipients was gradually improved over postoperative time, and the difference between two groups was statistically significant (P<0.05). In the MISS group, 15% (13/84) of the recipients developed acute rejection, and 27% (42/155) in the control group, and the difference was statistically significant (P<0.05). In the MISS group, the MISS score of the recipients with acute rejection was 0 (-2.5, 3.5), and -5.0 (-12.0, -1.0) for their counterparts without acute rejection, and the difference was statistically significant (P<0.05). In the MISS group, 2% (2/84) of the recipients presented with postoperative opportunistic infection, and 9% (14/155) in the control group, and the difference was statistically significant (P<0.05). In the MISS group, the 1- and 3-year overall survival rates were 86.9% and 79.8%, and 83.2% and 76.8% in the control group, and no significant difference was observed between two groups (P>0.05). Conclusions MICA and MISS score may reflect the immune status of liver transplant recipients, and guide the individualized management of administration of immunosuppressants after liver transplantation. [ABSTRACT FROM AUTHOR]

The red-handed howler monkey (Alouatta belzebul) is one of the 35 threatened Brazilian primate species found in two highly endangered Brazilian biomes. Their Amazonian native populations have been declining due to exponential deforestation associated with human activities, especially the construction of dams. The studied population (n = 27) was located in the Belo Monte dam Area of Influence. For the first time, we presented hematological parameters and the basic profile of T (CD3) and B (BSAP PAX5) cells by immunocytochemistry. The results supported the hypothesis that the immuno-hematological profile is influenced by sex, age, and season. Eosinophils were significantly higher in females (p = 0.03), monocytes statistically greater in juveniles (p = 0.04), and total plasma protein increased significantly (p > 0.001) during the dry season. Furthermore, adults showed a statistically higher average absolute number of B lymphocytes than young individuals (p = 0.03), in contrast to T lymphocytes. Even without knowing the full history of antigenic exposure, these results not only contribute to elucidating the boundaries between health and disease but may help lay the groundwork for future research into the effects of anthropogenic stress on immune activation. [ABSTRACT FROM AUTHOR]

Objective·To analyze the outcomes of treatment-free remission (TFR) after imatinib discontinuation in patients with chronic myeloid leukemia in chronic phase (CML-CP) who meet the criteria for TFR and are willing to monitor the disease regularly, the prognostic factors and the application of droplet digital polymerase chain reaction (ddPCR) technique in monitoring TFR. Methods·The patients with CML-CP enrolled in this study were monitored regularly after imatinib discontinuation. Molecular response and relapse were analyzed by quantitative polymerase chain reaction (QPCR) for detection of BCR-ABL transcripts. The lymphocytes subsets pre- and post-imatinib discontinuation were evaluated by flow cytometry. ddPCR was used to detect BCR-ABL and the predictive role in TFR was analyzed. Results· 1 Forty-two CML-CP patients who met the criteria for TFR were assessed. With median follow-up time 41(5-93) months, 32 (76.2%) patients maintained TFR.The estimated TFR rate by 12, 24 and 48 months were 85.1%, 75.1% and 70.1%, respectively. Median TFR duration was 41 (2-93) months. The most common adverse event post-discontinuation was musculoskeletal pain of grade I - II (31.0%). Eight patients achieved deep molecular response (DMR) after restart of imatinib. 2 58.3% of patients with continuous positive ddPCR developed molecular relapse after imatinib discontinuation, while none relapsed in those with negative detection (P<0.01). 3 The percentage of CD8+CD28- cells prediscontinuation was lower, while the percentage of CD4+CD25+ cells post-discontinuation was higher in relapsed patients than that in TFR patients (6.2% vs 12.6%, P=0.026; 3.2% vs 2.1%, P=0.021). Conclusion·CML-CP patients who meet the criteria of TFR may successfully maintain TFR after TKI discontinuation. ddPCR may help to predict the outcome of TFR and detect the molecular relapse earlier. Immune regulation by different T cell subsets may play a role in TFR duration to prevent relapse of disease. [ABSTRACT FROM AUTHOR]

Abstract Background Tens of million cases of coronavirus disease-2019 (COVID-19) have occurred globally. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) attacks the respiratory system, causing pneumonia and lymphopenia in infected individuals. The aim of the present study is to investigate the laboratory characteristics of the viral load, lymphocyte subset and cytokines in asymptomatic individuals with SARS-CoV-2 infection in comparison with those in symptomatic patients with COVID-19. Methods From January 24, 2020, to April 11, 2020, 48 consecutive subjects were enrolled in this study. Viral loads were detected by RT-PCR from throat-swab, sputum and feces samples. Lymphocyte subset levels of CD3 + , CD4 + , and CD8 + T lymphocytes, B cells and NK cells were determined with biological microscope and flow cytometric analysis. Plasma cytokines (IL2, IL4, IL5, IL6, IL8, IL10, TNF-α, IFN-α and IFN-γ) were detected using flow cytometer. Analysis of variance (ANOVA), Chi-square or Fisher's exact test and Pearson’s Correlation assay was used for all data. Results Asymptomatic (AS), mild symptoms (MS) and severe or critical cases (SCS) with COVID-19 were 11 (11/48, 22.9%), 26 (54.2%, 26/48) and 11 cases (11/48, 22.9%), respectively. The mean age of AS group (47.3 years) was lower than SCS group (63.5 years) (P

Abstract Background Early diagnostic indicators and the identification of possible progression to severe or critical COVID-19 in children are unknown. To investigate the immune characteristics of early SARS-CoV-2 infection in children and possible key prognostic factors for early identification of critical COVID-19, a retrospective study including 121 children with COVID-19 was conducted. Peripheral blood lymphocyte subset counts, T cell-derived cytokine concentrations, inflammatory factor concentrations, and routine blood counts were analyzed statistically at the initial presentation. Results The T lymphocyte subset and natural killer cell counts decreased with increasing disease severity. Group III (critical cases) had a higher Th/Tc ratio than groups I and II (common and severe cases); group I had a higher B cell count than groups II and III. IL-6, IL-10, IFN-γ, SAA, and procalcitonin levels increased with increasing disease severity. Hemoglobin concentration, and RBC and eosinophil counts decreased with increasing disease severity. Groups II and III had significantly lower lymphocyte counts than group I. T, Th, Tc, IL-6, IL-10, RBC, and hemoglobin had relatively high contribution and area under the curve values. Conclusions Decreased T, Th, Tc, RBC, hemoglobin and increased IL-6 and IL-10 in early SARS-CoV-2 infection in children are valuable indices for early diagnosis of severe disease. The significantly reduced Th and Tc cells and significantly increased IL-6, IL-10, ferritin, procalcitonin, and SAA at this stage in children with critical COVID-19 may be closely associated with the systemic cytokine storm caused by immune dysregulation.

Background: The role of lymphocyte subsets in the diagnosis and follow up of COVID-19 is still unclear. So, we aim to study the changes in lymphocyte subsets and HLA-DR expression in the peripheral blood of hospitalized COVID-19 patients. Methods: Lymphocyte subsets and HLA-DR expression were detected in the peripheral blood of 36 hospitalized patients of COVID-19; their data were compared to that of 36 healthy controls of comparable age and gender. Results: Total lymphocytes, the percentage of CD3 T, CD4 T and CD8 T cells significantly decreased, while that of CD 56 cells significantly increased in SARS-CoV-2 infected patients. The expression of HLA-DR is down regulated in these cells. Neutrophil/lymphocyte ratio, neutrophil/CD3 ratio, neutrophil/CD4 ratio, and neutrophil/CD8 ratio are significantly increased in patients compared with controls. The absolute count of CD3, CD4, CD8 and CD19 cells, significantly decreased in SARS-CoV-2 infected patients. Conclusions: A marked reduction in CD8+T and CD4+T count together with HLA-DR cell expression with obvious impairment in cellular immunity has been detected in patients with more severe impairment and progressive course for the disease. [ABSTRACT FROM AUTHOR]

Introduction Acute myeloid leukemia (AML) is a heterogenous disorder consisting of clonal expansion of myeloblasts. Tumor immunity plays an important part in the pathobiology of AML. Understanding the components of tumor immunity is important for understanding tumor pathogenesis and the principles of immunotherapy. Methods We studied 41 patients with AML, for total lymphocyte, CD4 positive helper T cells, CD8 positive cytotoxic T cells, and CD16/56 positive natural killer (NK) cells proportion. Quantification was done on bone marrow aspirate sample by flowcytometry. Whenever available, post induction bone marrow was also analyzed for the lymphocyte subset. Results No significant difference was noted in the percentage of blasts among the three risk categories: favorable, intermediate, and adverse. However, there was significant difference in the total lymphocyte among the risk stratification groups, being highest in the favorable group and lowest in the adverse group. CD8 positive cytotoxic T cells were significantly less in Acute Promyelocytic Leukemia (APML) cases (p = 0.001). Total lymphocytes were, however, more numerous in APML (p = 0.005). NK cell proportion was not significantly different between APML and non-APML patients. On completion of induction chemotherapy, bone marrow samples for 12 patients could be processed for lymphocyte subset. On comparing the baseline against the post induction bone marrow, it was observed that there was significant increment in the proportion of CD4 positive T lymphocytes (p = 0.046). Conclusion There is a difference in lymphocyte subset amongst patients with AML. Larger studies including functional aspects are needed to better define the role of lymphocytes in disease pathogenesis. [ABSTRACT FROM AUTHOR]

ObjectivesWe aimed to explore the alteration of circulating lymphocyte subsets before and after tacrolimus (TAC) therapy in neuromyelitis optica spectrum disorder (NMOSD) and its correlation with clinical outcomes.MethodsAnti-aquaporin-4 antibody (AQP4-ab)-positive patients with NMOSD treated with TAC were followed and clinically evaluated at 0, 3, 6, and 12 months after initiation of TAC. Flow cytometry was employed to detect the proportion of various whole blood lymphocyte subsets at every time point. Correlation analysis was further performed to explore the association between annualized relapse rate (ARR), the Expanded Disability Status Scale (EDSS) score, and the proportion of circulating lymphocyte subsets before and after TAC therapy.ResultsA total of 13 eligible patients with NMOSD were included. The proportion of CD19+CD24hiCD38hi/CD19+ and CD19+CD5+CD1dhi/CD19+ lymphocyte subsets increased significantly after TAC therapy (p = 0.010 and p < 0.001). The proportion of CD19+BAFFR+, CD19+IFN-γ+, and CD19+IL-10+ subsets decreased significantly after TAC therapy (p = 0.015, 0.018, and 0.042, respectively). There was a negative correlation between CD4+CD25hi subset and EDSS score (p = 0.016, r = −0.652).ConclusionPossibly through increasing regulatory B and suppressing BAFFR+ B and interferon (IFN)-γ+ B subsets, TAC could decrease relapse. EDSS score may be correlated with some lymphocyte subsets after TAC therapy.

Objectives: We aimed to explore the alteration of circulating lymphocyte subsets before and after tacrolimus (TAC) therapy in neuromyelitis optica spectrum disorder (NMOSD) and its correlation with clinical outcomes. Methods: Anti-aquaporin-4 antibody (AQP4-ab)-positive patients with NMOSD treated with TAC were followed and clinically evaluated at 0, 3, 6, and 12 months after initiation of TAC. Flow cytometry was employed to detect the proportion of various whole blood lymphocyte subsets at every time point. Correlation analysis was further performed to explore the association between annualized relapse rate (ARR), the Expanded Disability Status Scale (EDSS) score, and the proportion of circulating lymphocyte subsets before and after TAC therapy. Results: A total of 13 eligible patients with NMOSD were included. The proportion of CD19+CD24hiCD38hi/CD19+ and CD19+CD5+CD1dhi/CD19+ lymphocyte subsets increased significantly after TAC therapy (p = 0.010 and p < 0.001). The proportion of CD19+BAFFR+, CD19+IFN-γ+, and CD19+IL-10+ subsets decreased significantly after TAC therapy (p = 0.015, 0.018, and 0.042, respectively). There was a negative correlation between CD4+CD25hi subset and EDSS score (p = 0.016, r = −0.652). Conclusion: Possibly through increasing regulatory B and suppressing BAFFR+ B and interferon (IFN)-γ+ B subsets, TAC could decrease relapse. EDSS score may be correlated with some lymphocyte subsets after TAC therapy. [ABSTRACT FROM AUTHOR]

Objective To investigate the predictive and diagnostic value of absolute value and function of different lymphocyte subsets in evaluating the risk of early viral infection after kidney transplantation. Methods Ninety-five kidney transplant recipients were enrolled in this prospective observational cohort study, and divided into the stable group (n=77) and infection group (n=18) according to postoperative immune status. Peripheral blood samples were collected for flow cytometry before operation, and 2 weeks, 1 month, 2 months and 6 months after operation. The dynamic changes of the absolute values of CD4+ T cells, CD8+ T cells and natural killer (NK) cells were compared between two groups. The function of lymphocyte subsets in two groups was evaluated by detecting the proportion of interferon (IFN)-γ+ CD4+ T cells, IFN-γ+ CD8+ T cells and IFN-γ+ NK cells. The value of the absolute values and function of lymphocyte subsets in predicting and diagnosing viral infection in the early stage after kidney transplantation was evaluated. Results During viral infection, the absolute values of CD4+ T cells, CD8+ T cells and NK cells in the infection group were at a relatively low level. At 2 months after operation, the absolute values of CD4+ T cells and NK cells in the infection group were lower than those in the stable group. At 6 months after operation, the absolute values of CD4+ T cells and CD8+ T cells in the infection group were significantly lower compared with those in the stable group (all P<0.05). During viral infection, the proportion of IFN-γ+ CD4+ T cells, IFN-γ+ CD8+ T cells and IFN-γ+ NK cells in the infection group were all at a relatively low level, especially that of IFN-γ+ CD8+ T cells decreased most significantly. At postoperative 2 months, the proportion of IFN-γ+ CD8+ T cells and IFN-γ+ NK cells in the infection group was significantly higher than those in the stable group. At 6 months after operation, the proportion of IFN-γ+ CD4+ T cells and IFN-γ+ CD8+ T cells in the infection group was significantly higher than those in the stable group (all P<0.05). Logistic regression analysis showed that the increasing proportion of IFN-γ+ CD8+ T cells and IFN-γ+ NK cells was correlated with the increasing risk of viral infection at 2 months after operation (both P<0.05). The receiver operating characteristic (ROC) curve demonstrated that the diagnostic value of absolute values of lymphocyte subsets combined with IFN-γ secretion function for viral infection in the immunocompromised recipients was significantly higher than that of absolute values of lymphocyte subsets alone (P<0.05). Conclusions Dynamic monitoring of the changes of absolute values and function of lymphocyte subsets provides critical reference value for the prediction, diagnosis and medication guidance of viral infection. [ABSTRACT FROM AUTHOR]

Background & objectives: The COVID-19 disease profile in Indian patients has been found to be different from the Western world. Changes in lymphocyte compartment have been correlated with disease course, illness severity and clinical outcome. This study was aimed to assess the peripheral lymphocyte phenotype and subset distribution in patients with COVID-19 disease from India with differential clinical manifestations. Methods: Percentages of peripheral lymphocyte subsets were measured by flow cytometry in hospitalized asymptomatic (n=53), mild symptomatic (n=36), moderate and severe (n=30) patients with SARS-CoV-2 infection, recovered individuals (n=40) and uninfected controls (n=56) from Pune, Maharashtra, India. Results: Percentages of CD4+Th cells were significantly high in asymptomatic, mild symptomatic, moderate and severe patients and recovered individuals compared to controls. Percentages of Th memory (CD3+CD4+CD45RO+), Tc memory (CD3+CD8+CD45RO+) and B memory (CD19+CD27+) cells were significantly higher in the recovered group compared to both asymptomatic, mild symptomatic patient and uninfected control groups. NK cell (CD56+CD3-) percentages were comparable among moderate +severe patient and uninfected control groups. Interpretation & conclusions: The observed lower CD4+Th cells in moderate+severe group requiring oxygen support compared to asymptomatic+mild symptomatic group not requiring oxygen support could be indicative of poor prognosis. Higher Th memory, Tc memory and B memory cells in the recovered group compared to mild symptomatic patient groups might be markers of recovery from mild infection; however, it remains to be established if the persistence of any of these cells could be considered as a correlate of protection. [ABSTRACT FROM AUTHOR]

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Background: Tens of million cases of coronavirus disease-2019 (COVID-19) have occurred globally. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) attacks the respiratory system, causing pneumonia and lymphopenia in infected individuals. The aim of the present study is to investigate the laboratory characteristics of the viral load, lymphocyte subset and cytokines in asymptomatic individuals with SARS-CoV-2 infection in comparison with those in symptomatic patients with COVID-19. Methods: From January 24, 2020, to April 11, 2020, 48 consecutive subjects were enrolled in this study. Viral loads were detected by RT-PCR from throat-swab, sputum and feces samples. Lymphocyte subset levels of CD3 + , CD4 + , and CD8 + T lymphocytes, B cells and NK cells were determined with biological microscope and flow cytometric analysis. Plasma cytokines (IL2, IL4, IL5, IL6, IL8, IL10, TNF-α, IFN-α and IFN-γ) were detected using flow cytometer. Analysis of variance (ANOVA), Chi-square or Fisher's exact test and Pearson's Correlation assay was used for all data. Results: Asymptomatic (AS), mild symptoms (MS) and severe or critical cases (SCS) with COVID-19 were 11 (11/48, 22.9%), 26 (54.2%, 26/48) and 11 cases (11/48, 22.9%), respectively. The mean age of AS group (47.3 years) was lower than SCS group (63.5 years) (P < 0.05). Diabetes mellitus in AS, MS and SCS patients with COVID-19 were 0, 6 and 5 cases, respectively, and there was a significant difference between AS and SCS (P < 0.05). No statistical differences were found in the viral loads of SARS-CoV-2 between AS, MS and SCS groups on admission to hospital and during hospitalization. The concentration of CD 3 + T cells (P < 0.05), CD3 + CD4 + T cells (P < 0.05), CD3 + CD8 + T cells (P < 0.01), and B cells (P < 0.05) in SCS patients was lower than in AS and MS patients, while the level of IL-5 (P < 0.05), IL-6 (P < 0.05), IL-8 (P < 0.01) and IL-10 (P < 0.01), and TNF-α (P < 0.05) was higher. The age was negatively correlated with CD3 + T cells (P < 0.05), CD3 + CD4 + T cells (P < 0.05), and positively correlated with IL-2 (P < 0.001), IL-5 (P < 0.05), IL-6 (P < 0.05) IL-8 (P < 0.05), and IL-10 (P < 0.05). The viral loads were positively correlated with IL-2 (P < 0.001), IL-5 (P < 0.05), IL-6 (P < 0.05) IL-8 (P < 0.05) and IL-10 (P < 0.05), while negatively correlated with CD 3 + T cells (P < 0.05) and CD3 + CD4 + T cells (P < 0.05). Conclusions: The viral loads are similar between asymptomatic, mild and severe or critical patients with COVID-19. The severity of COVID-19 may be related to underlying diseases such as diabetes mellitus. Lymphocyte subset and plasma cytokine levels may be as the markers to distinguish severely degrees of disease, and asymptomatic patients may be as an important source of infection for the COVID-19. [ABSTRACT FROM AUTHOR]

Background: Early diagnostic indicators and the identification of possible progression to severe or critical COVID-19 in children are unknown. To investigate the immune characteristics of early SARS-CoV-2 infection in children and possible key prognostic factors for early identification of critical COVID-19, a retrospective study including 121 children with COVID-19 was conducted. Peripheral blood lymphocyte subset counts, T cell-derived cytokine concentrations, inflammatory factor concentrations, and routine blood counts were analyzed statistically at the initial presentation.Results: The T lymphocyte subset and natural killer cell counts decreased with increasing disease severity. Group III (critical cases) had a higher Th/Tc ratio than groups I and II (common and severe cases); group I had a higher B cell count than groups II and III. IL-6, IL-10, IFN-γ, SAA, and procalcitonin levels increased with increasing disease severity. Hemoglobin concentration, and RBC and eosinophil counts decreased with increasing disease severity. Groups II and III had significantly lower lymphocyte counts than group I. T, Th, Tc, IL-6, IL-10, RBC, and hemoglobin had relatively high contribution and area under the curve values.Conclusions: Decreased T, Th, Tc, RBC, hemoglobin and increased IL-6 and IL-10 in early SARS-CoV-2 infection in children are valuable indices for early diagnosis of severe disease. The significantly reduced Th and Tc cells and significantly increased IL-6, IL-10, ferritin, procalcitonin, and SAA at this stage in children with critical COVID-19 may be closely associated with the systemic cytokine storm caused by immune dysregulation. [ABSTRACT FROM AUTHOR]

The prognosis of COVID-19 (coronavirus disease 2019) is usually poor when it occurs in aged adults or in patients with chronic diseases, which brought a great challenge to clinical practice. Furthermore, widespread depression, anxiety, and panic related to SARS-CoV-2 (severe acute respiratory syndrome-coronavirus 2) infection affected treatment compliance and recovery. Here we report the successful treatment of a 57-year-old male with severe COVID-19, schizophrenia, hypertension, and type 2 diabetes. The patient's negative emotions (such as tension, panic, and anxiety), particularly his aggression and paranoia, seriously hindered treatment, leading to a deteriorating condition. Psychological counseling and supportive psychotherapy were given but the effect was weak. To improve adherence, risperidone and quetiapine fumarate were replaced by olanzapine for anti-schizophrenic treatment to reduce insomnia and anxiety side effects, associated with sedative-hypnotic drugs as well as psychological counseling. The treatment compliance of the patient improved significantly. The patient's serum alanine aminotransferase increased abnormally in the late stage of hospitalization, suggesting potential liver damage after complex medication strategies. We also monitored the changes of lymphocyte subsets and retrospectively analyzed the virus-specific antibody response. The results suggested that dynamic monitoring of lymphocyte subsets and virus-specific antibody response could facilitate disease progression evaluation and timely treatment plan adjustments. An effective psychotropic drug intervention associated with psychological counselling and psychotherapy are essential for the successful adherence, treatment, and rehabilitation of psychiatric disorders in COVID-19 patients.

ObjectiveThis study aimed to evaluate the factors associated with death in patients with coronavirus disease 2019 by clarifying the clinical characteristics and immune responses.MethodsThe clinical characteristics and laboratory findings, including cytokine and lymphocyte subsets, were obtained from the electronic medical records of patients in Wuhan Tongji Hospital.ResultsThis study included 836 patients with confirmed COVID-19. In total, 699 (83.6%) were cured and discharged, and 137 (16.4%) died. Our analysis revealed that age ≥ 65 years, male sex, malignancy, chronic obstructive pulmonary disease, dyspnea, dizziness, respiratory rate > 20 bpm, heart rate > 100 bpm, systolic blood pressure < 90 mmHg, neutrophils > 6.3×109/L, lymphopenia, thrombocytopenia, D-dimer ≥ 0.5 mg/L, lactate dehydrogenase > 250 U/L, aspartate aminotransferase > 40 U/L, total bilirubin > 26 μmol/L, albumin < 35 g/L, blood urea nitrogen > 9.5 mmol/L, estimated glomerular filtration rate < 90 ml/min/1.73, elevated cardiac troponin I, N-terminal pro-brain natriuretic peptide ≥ 900 pg/ml, C-reactive protein ≥ 25 mg/L, procalcitonin ≥ 0.05 ng/ml and ferritin > 400 μg/L were associated with death in patients with COVID-19. The multivariate logistic regression analysis revealed that an estimated glomerular filtration rate < 90 ml/min/1.73, elevated cardiac troponin I, C-reactive protein ≥ 25 mg/L and procalcitonin ≥ 0.05 ng/ml were predictive of mortality. Regarding immune responses, IL-2R, IL-6, IL-8, IL-10, and TNFα were remarkably higher in the deceased group at admission, and the levels of IL-2R, IL-6, IL-8, IL-10, and TNFα in the deceased group showed a rapid increase; the dynamics of these cytokines were highly consistent with disease deterioration. Lymphocyte subset analysis revealed that the deceased patients showed significant decreases in lymphocyte counts, especially helper T cells, suppressor T cells and NK cells.ConclusionsThis study identified that an estimated glomerular filtration rate < 90 ml/min/1.73, elevated cardiac troponin I, C-reactive protein ≥ 25 mg/L and procalcitonin ≥ 0.05 ng/ml were predictors of mortality in COVID-19 patients. Elevated cytokine levels and a continued increasing trend, including in IL-2R, IL-6, IL-8, IL-10 and TNFα, and a decrease in lymphocyte subsets, especially helper T cells, suppressor T cells and NK cells, were associated with a poor prognosis.

Objective: This study aimed to evaluate the factors associated with death in patients with coronavirus disease 2019 by clarifying the clinical characteristics and immune responses. Methods: The clinical characteristics and laboratory findings, including cytokine and lymphocyte subsets, were obtained from the electronic medical records of patients in Wuhan Tongji Hospital. Results: This study included 836 patients with confirmed COVID-19. In total, 699 (83.6%) were cured and discharged, and 137 (16.4%) died. Our analysis revealed that age ≥ 65 years, male sex, malignancy, chronic obstructive pulmonary disease, dyspnea, dizziness, respiratory rate > 20 bpm, heart rate > 100 bpm, systolic blood pressure < 90 mmHg, neutrophils > 6.3×109/L, lymphopenia, thrombocytopenia, D-dimer ≥ 0.5 mg/L, lactate dehydrogenase > 250 U/L, aspartate aminotransferase > 40 U/L, total bilirubin > 26 μmol/L, albumin < 35 g/L, blood urea nitrogen > 9.5 mmol/L, estimated glomerular filtration rate < 90 ml/min/1.73, elevated cardiac troponin I, N-terminal pro-brain natriuretic peptide ≥ 900 pg/ml, C-reactive protein ≥ 25 mg/L, procalcitonin ≥ 0.05 ng/ml and ferritin > 400 μg/L were associated with death in patients with COVID-19. The multivariate logistic regression analysis revealed that an estimated glomerular filtration rate < 90 ml/min/1.73, elevated cardiac troponin I, C-reactive protein ≥ 25 mg/L and procalcitonin ≥ 0.05 ng/ml were predictive of mortality. Regarding immune responses, IL-2R, IL-6, IL-8, IL-10, and TNFα were remarkably higher in the deceased group at admission, and the levels of IL-2R, IL-6, IL-8, IL-10, and TNFα in the deceased group showed a rapid increase; the dynamics of these cytokines were highly consistent with disease deterioration. Lymphocyte subset analysis revealed that the deceased patients showed significant decreases in lymphocyte counts, especially helper T cells, suppressor T cells and NK cells. Conclusions: This study identified that an estimated glomerular filtration rate < 90 ml/min/1.73, elevated cardiac troponin I, C-reactive protein ≥ 25 mg/L and procalcitonin ≥ 0.05 ng/ml were predictors of mortality in COVID-19 patients. Elevated cytokine levels and a continued increasing trend, including in IL-2R, IL-6, IL-8, IL-10 and TNFα, and a decrease in lymphocyte subsets, especially helper T cells, suppressor T cells and NK cells, were associated with a poor prognosis. [ABSTRACT FROM AUTHOR]

Objective To evaluate the clinical value of lymphocyte subset classification in the diagnosis of active pulmonary tuberculosis in renal transplant recipients. Methods Clinical data of 52 recipients undergoing renal transplantation were retrospectively analyzed. According to the results of imaging and etiological examination, 52 recipients were divided into the stable group(n=19), tuberculosis group (n=9), bacteria group (n=12) and fungi group (n=12), respectively. The renal function of recipients was compared, and the proportion and absolute value of lymphocyte subset were analyzed and compared among four groups. The diagnostic value of lymphocyte subset classification for active pulmonary tuberculosis after renal transplantation was evaluated. Results Compared with the stable group, the levels of blood urea nitrogen and serum creatinine in the tuberculosis group, bacteria group and fungi group were significantly increased (all P<0.05). The proportion of CD3+ , CD8+ , CD4+ , natural killer (NK) cells and CD19+ lymphocyte subsets were not significantly different (all P>0.05). And the absolute values of CD3+ , CD8+ , CD4+ , NK cells and CD19+ lymphocyte subsets were significantly decreased (all P<0.05). The proportion of CD8+ lymphocyte subset in the tuberculosis group and fungi group was significantly higher than that in the bacteria group (both P<0.05). The optimal cut-off value of CD8+ lymphocyte subset ratio in the differential diagnosis of active pulmonary tuberculosis and bacterial pneumonia was 33.27%, and the sensitivity and specificity were 0.889 and 0.833, respectively. The area under the curve (AUC) was 0.880. Conclusions The classification of lymphocyte subset can provide auxiliary diagnostic basis for differential diagnosis and individualized treatment of active pulmonary tuberculosis and bacterial pneumonia in renal transplant recipients. [ABSTRACT FROM AUTHOR]

Objective To investigate the dynamic changes of peripheral blood lymphocyte subsets and their correlation with renal function in recipients with stable graft status after renal transplantation. Methods Forty-five recipients who underwent renal transplantation for the first time and had stable graft function within postoperative 6 months were selected. The proportion and absolute value of lymphocyte subsets were detected by flow cytometry (FCM) in 180 peripheral blood samples from recipients at 15 d, 1, 3 and 6 months after renal transplantation. The dynamic changes of lymphocyte subsets with the extension of postoperative time and their correlation with serum creatinine (Scr) and blood urea nitrogen (BUN) were analyzed. Results The Scr levels did not significantly differ at 4 time points after renal transplantation (all P>0.05). The BUN levels significantly differed between 15 d and 1 month after renal transplantation, and between 1 and 3 months after renal transplantation (P=0.002, P=0.001). The proportion of CD3+ CD8+ T cells, CD3+ CD4+ T cells, natural killer (NK) cells and CD4/CD8 ratio at postoperative 15 d significantly differed from those at 1 month after operation (P=0.009, P=0.004, P<0.001, P=0.004). The proportion of B cells significantly differed between 15 d and 1 month, and between 1 and 3 months after renal transplantation (both P<0.001). The absolute values of CD3+ T cells, CD3+ CD8+ T cells, CD3+ CD4+ T cells and NK cells at postoperative 15 d significantly differed from those at 1 month after renal transplantation (P=0.001, P=0.002, P=0.003, P<0.001). The absolute values of CD3+ CD8+ T cells significantly differed between 3 and 6 months after operation (P=0.015). The absolute value of B cells at 1 month after renal transplantation significantly differed from that at 3 months after renal transplantation (P=0.001). The proportion and absolute value of lymphocyte subsets were not significantly correlated with the Scr level (both P>0.05). The proportion and absolute value of CD3+ CD8+ T cells and NK cells were negatively correlated with BUN (P<0.001-0.05), whereas the proportion of CD3+ CD4+ T cells and B cells was positively correlated with the BUN level (P<0.001-0.05). The absolute value of CD3+ T cells was negatively associated with the BUN level (P<0.05). Conclusions T cells and NK cells in the lymphocyte subsets of stable recipients raise to the stable state within 1 month after renal transplantation, whereas B cells decrease to stable state within 3 months renal transplantation. The dynamic changes of lymphocyte subsets are correlated with the BUN level. [ABSTRACT FROM AUTHOR]

A reduced peripheral blood absolute lymphocyte count with an elevated neutrophil count has been a consistent observation in hospitalized coronavirus disease 2019 (COVID‐19) patients. In this brief meta‐analysis, the reduction of lymphocyte subset counts in COVID‐19 patients was investigated across 20 peer‐reviewed studies meeting criteria for reporting lymphocyte subset counts and COVID‐19 disease severity. CD4+ T cell, CD8+ T cell, B cell, NK cell, and total lymphocyte cell counts all showed statistically significant reduction in patients with severe/critical COVID‐19 disease compared to mild/moderate disease. T‐cell subsets showed the largest standardized magnitude of change. In some studies, multivariate analysis has shown that CD4 and/or CD8 T‐cells counts are independently predictive of patient outcomes. © 2020 International Society for Advancement of Cytometry [ABSTRACT FROM AUTHOR]

Background: In December 2019, novel coronavirus (SARS-CoV-2) pneumonia (COVID-19) was reported in Wuhan and has since rapidly spread throughout China. We aimed to clarify the characteristics and clinical significance of peripheral lymphocyte subset alteration in COVID-19.Methods: The levels of peripheral lymphocyte subsets were measured by flow cytometry in 60 hospitalized COVID-19 patients before and after treatment, and their association with clinical characteristics and treatment efficacy was analyzed.Results: Total lymphocytes, CD4+ T cells, CD8+ T cells, B cells, and natural killer (NK) cells decreased in COVID-19 patients, and severe cases had a lower level than mild cases. The subsets showed a significant association with inflammatory status in COVID-19, especially CD8+ T cells and CD4+/CD8+ ratio. After treatment, 37 patients (67%) showed clinical response, with an increase in CD8+ T cells and B cells. No significant change in any subset was detected in nonresponsive cases. In multivariate analysis, posttreatment decrease in CD8+ T cells and B cells and increase in CD4+/CD8+ ratio were indicated as independent predictors of poor efficacy.Conclusions: Peripheral lymphocyte subset alteration was associated with clinical characteristics and treatment efficacy of COVID-19. CD8+ T cells tended to be an independent predictor for COVID-19 severity and treatment efficacy. [ABSTRACT FROM AUTHOR]

Background. The state of the recipient’s immune system may influence significantly the results of transplantation and should be taken into account when choosing the tactics of immunosuppressive therapy. Materials and me­thods. The retrospective analysis of cytometric peripheral blood lymphocytes examination: T cells (CD3+, CD19–), T-helper cells (CD3+, CD4+), T-cytotoxic (CD3+, CD8+), T-activated (CD3+, HLA-DR+), T-NK cells (CD3+, CD16+56+), B cells (CD3–, CD19+, HLA-DR+), NK-cells (CD3–, CD16+56+) was done in 40 adult and 20 pediatric patients with end stage renal disease (ESRD) on haemodialysis the day before kidney transplantation in O.O. Shalimov National Institute of Surgery and Transplantation. Results. Higher B-lymphocytes and lower T-cytotoxic and T-activated levels were found in children with end stage renal disease compared to adult patients. There were also tendencies to decreased T-NK and NK-cell levels, as well as to increased CD4+/CD8+ ratio in pediatric patients. The state of immune system in pediatric patients with ESRD before transplantation differs from that in adults. But, taking into account the contradictory published data on this issue, we consider it necessary to continue the investigation with a mandatory analysis of parameters dynamics in posttransplant period. Conclusions. The differences of lymphocyte subsets repertoire in children before kidney transplantation should be considered when choosing optimal scheme of immunosuppressive therapy.

Objectives: Fingolimod (FTY) potentially inhibits the disease activity of multiple sclerosis (MS), but induces severe lymphocytopenia that might be related viral infections, including progressive multifocal leukoencephalopathy. We use a reduced dosage of FTY treatment to avoid its cessation because of lymphocytopenia. FTY inhibits the egress of CD62L+ cells from lymph nodes, and the number of CD4+CD62L+ cells, a major population of CD62L+ cells, in blood is a maker to evaluate the strength of FTY action in patients with MS treated by intermittent drug holidays of FTY. Methods: A total of 24 Japanese patients with MS were treated with variable dosages of FTY initially based on the number of lymphocytes, and then changed to CD4+CD62L+ cell counts as a marker. Fluorescence‐activated cell sorting analysis was used to evaluate the number of CD4+CD62L+ cells in fresh blood of 21 MS patients treated with FTY for 30–94 months, including the mean period of 27.5 months of daily administration. Results: The CD4+CD62L+ cell counts and the proportion of patients with <2% CD4+CD62L+ cells in total lymphocytes declined from 12 ± 13 cells/mm3 (median 8 cells/mm3) to 31 ± 4 cells/mm3 (median 27 cells/mm3) and 61.5% to 0%, respectively, after further dosage reduction. Their annual relapse rates were kept to <0.03, even after inducing CD4+CD62L+ counts as a monitoring marker. The target range of CD4+CD62L+cells on reduction of FTY dosage was 10–80 cells/mm3. Conclusions: It is critical to monitor CD4+CD62L+ cells rather than total lymphocyte count to avoid excessive FTY administration. [ABSTRACT FROM AUTHOR]