Correlation between the unbalanced lymphocyte subsets and the aggravation condition of hand, foot and mouth disease with EV71 infection

doi:10.3877/cma.j.issn.1674-1358.2017.02.011

Abstract

Abstract:

Objective

To investigate the correlation between the unbalanced lymphocyte subsets and the aggravation condition of children with EV71-assoicated hand, foot and mouth disease (HFMD).

Methods

Total of 496 patients with EV71-assoicated HFMD were collected in the hospital from April 2013 to October 2015, and were divided into the common group (220 cases), severe group (191 cases) and critical group (85 cases). While 100 healthy children who received checkup during the same period were recruited in the control group. The lymphocyte subsets in peripheral blood, including T lymphocytes (CD3⁺), Th cells (CD3⁺CD4⁺), Tc cells (CD3⁺CD8⁺), NK cells (CD16⁺56⁺) and B lymphocytes (CD19⁺) were detected by flowcytometry in terms of count and percentage in total lymphocytes. And the serum levels of IL-6, IL-10, TNF-α and IFN-γ were determined by ELISA.

Results

The percentages of such lymphocyte subsets as CD3⁺, CD3⁺CD4⁺ and CD3⁺CD8⁺ were decreased sequentially in the control group, and the common, severe and critical groups; and the oppositely sequential decline was indicated in the percentage of CD19⁺. The percentage of CD16⁺CD56⁺ was reduced sequentially in the control group, and the severe, common and critical groups. The lymphocyte subsets were significantly different among the patients in different groups (F = 243.38, 206.52, 41.85, 4.27, 314.54; all P < 0.05). In inter-group comparison, no significant difference of CD3⁺CD4⁺ was observed between the severe and critical groups (all P > 0.05), and no significant difference of CD16⁺CD56⁺ were observed between the control group and the severe group and also between the common and critical groups (all P > 0.05); a significant difference of the other subsets was indicated among the four groups (all P < 0.05). The levels of such cytokines as IL-6 and IL-10 were increased sequentially in the control group, and the common, severe and critical groups; the levels of TNF-α and IFN-γ were increased sequentially in the control group, the common and severe groups, but decreased in the critical group. The levels of the cytokines were significantly different among the four groups (F = 55.32, 75.47, 416.37, 321.31; all P < 0.05), a significant difference was also observed in multiple inter-group comparisons (all P < 0.05).

Conclusions

The children with EV71-assoicated HFMD had disordered cellular immune function and abnormal inflammatory factors. And the unbalanced lymphocyte subsets may play an important role in the aggravation condition in those with HFMD.

Key words: Hand, foot and mouth disease, Human enterovirus 71, Immune function, Lymphocyte subsets, Cytokines

Jun Wang, Huiling Deng, Juan Yuan, Yufeng Zhang, Yaping Li, Mei Li, Wenjun Wang, Ning Gao, Shuangsuo Dang. Correlation between the unbalanced lymphocyte subsets and the aggravation condition of hand, foot and mouth disease with EV71 infection[J]. Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition), 2017, 11(02): 156-161.

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References 26

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组别	例数	CD3⁺	CD3⁺CD4⁺	CD3⁺CD8⁺	CD16⁺CD56⁺	CD19⁺
对照组	100	68.95±8.31	44.60±10.50	27.05±8.12	13.15±6.19	14.10±6.75
普通型组	220	59.50±9.72^a	29.65±8.68^a	22.05±10.79^a	11.20±5.62^a	21.65±9.21^a
重症组	191	44.72±10.58^ab	21.55±7.39^ab	17.92±6.41^ab	12.73±7.48^b	39.34±10.58^ab
危重症组	85	38.38±7.45^abc	19.57±5.42^ab	14.76±4.99^abc	10.57±6.79^ac	47.76±9.99^abc
F值		243.380	206.520	41.850	4.270	314.540
P值		< 0.001	< 0.001	< 0.001	0.005	< 0.001

组别	例数	CD3⁺	CD3⁺CD4⁺	CD3⁺CD8⁺	CD16⁺CD56⁺	CD19⁺
对照组	100	68.95±8.31	44.60±10.50	27.05±8.12	13.15±6.19	14.10±6.75
普通型组	220	59.50±9.72^a	29.65±8.68^a	22.05±10.79^a	11.20±5.62^a	21.65±9.21^a
重症组	191	44.72±10.58^ab	21.55±7.39^ab	17.92±6.41^ab	12.73±7.48^b	39.34±10.58^ab
危重症组	85	38.38±7.45^abc	19.57±5.42^ab	14.76±4.99^abc	10.57±6.79^ac	47.76±9.99^abc
F值		243.380	206.520	41.850	4.270	314.540
P值		< 0.001	< 0.001	< 0.001	0.005	< 0.001

淋巴细胞亚群	对照组						普通型组				重症组
	普通型		重型组		危重型组		重症组		危重症组		危重症组
	q值	P值	q值	P值	q值	P值	q值	P值	q值	P值	q值	P值
CD3⁺	11.66	< 0.01	29.21	< 0.01	30.83	< 0.01	22.24	< 0.01	24.61	< 0.01	7.23	< 0.01
CD3⁺CD4⁺	21.25	< 0.01	32.02	< 0.01	29.09	< 0.01	14.04	< 0.01	13.53	< 0.01	2.59	> 0.05
CD3⁺CD8⁺	6.96	< 0.01	12.43	< 0.01	14.00	< 0.01	7.01	< 0.01	9.59	< 0.01	4.07	< 0.01
CD16⁺CD56⁺	3.50	< 0.05	0.73	> 0.05	3.78	< 0.05	3.35	< 0.05	1.06	> 0.05	3.58	< 0.05
CD19⁺	9.37	< 0.01	30.63	< 0.01	34.18	< 0.01	26.80	< 0.01	30.63	< 0.01	9.67	< 0.01

淋巴细胞亚群	对照组						普通型组				重症组
	普通型		重型组		危重型组		重症组		危重症组		危重症组
	q值	P值	q值	P值	q值	P值	q值	P值	q值	P值	q值	P值
CD3⁺	11.66	< 0.01	29.21	< 0.01	30.83	< 0.01	22.24	< 0.01	24.61	< 0.01	7.23	< 0.01
CD3⁺CD4⁺	21.25	< 0.01	32.02	< 0.01	29.09	< 0.01	14.04	< 0.01	13.53	< 0.01	2.59	> 0.05
CD3⁺CD8⁺	6.96	< 0.01	12.43	< 0.01	14.00	< 0.01	7.01	< 0.01	9.59	< 0.01	4.07	< 0.01
CD16⁺CD56⁺	3.50	< 0.05	0.73	> 0.05	3.78	< 0.05	3.35	< 0.05	1.06	> 0.05	3.58	< 0.05
CD19⁺	9.37	< 0.01	30.63	< 0.01	34.18	< 0.01	26.80	< 0.01	30.63	< 0.01	9.67	< 0.01

组别	例数	IL-6	TNF-α	IFN-γ	IL-10
对照组	100	9.25±5.48	18.3±5.65	20.19±10.15	8.59±2.62
普通型组	220	16.38±7.59^a	20.6±10.24^a	45.07±12.31^a	18.31±5.61^a
重症组	191	20.21±9.71^ab	28.9±8.61^ab	69.22±18.61^ab	24.59±4.95^ab
危重症组	85	22.94±8.23^abc	14.5±3.04^abc	15.02±10.45^abc	32.15±8.57^abc
F值		55.320	75.470	416.370	321.310
P值		< 0.001	< 0.001	< 0.001	< 0.001

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