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Compartmental immunophenotyping in COVID-19 ARDS: A case series.
- Source :
-
The Journal of allergy and clinical immunology [J Allergy Clin Immunol] 2021 Jan; Vol. 147 (1), pp. 81-91. Date of Electronic Publication: 2020 Oct 23. - Publication Year :
- 2021
-
Abstract
- 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.<br />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).<br />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.<br />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 <subscript>H</subscript> 17 cells were found in higher fractions in the lung. Lung CD4 and CD8 T cells and macrophages expressed an even higher upregulation of activation markers than in blood. A wide range of cytokines were expressed at high levels both in the blood and in the lungs, most notably, IL-1RA, IL-6, IL-8, IP-10, and monocyte chemoattactant protein-1, consistent with hyperinflammation.<br />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.<br /> (Copyright © 2020 The Authors. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Adult
Aged
CD8-Positive T-Lymphocytes pathology
COVID-19 pathology
Cross-Sectional Studies
Cytokines immunology
Female
Humans
Immunophenotyping
Lung pathology
Lymphopenia pathology
Male
Middle Aged
Respiratory Distress Syndrome pathology
Th17 Cells pathology
CD8-Positive T-Lymphocytes immunology
COVID-19 immunology
Lung immunology
Lymphopenia immunology
Respiratory Distress Syndrome immunology
SARS-CoV-2 immunology
Th17 Cells immunology
Subjects
Details
- Language :
- English
- ISSN :
- 1097-6825
- Volume :
- 147
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- The Journal of allergy and clinical immunology
- Publication Type :
- Academic Journal
- Accession number :
- 32979342
- Full Text :
- https://doi.org/10.1016/j.jaci.2020.09.009