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Compartmental immunophenotyping in COVID-19 ARDS: A case series
- Source :
- The Journal of Allergy and Clinical Immunology, Ronit, A, Berg, R M G, Bay, J T, Haugaard, A K, Ahlström, M G, Burgdorf, K S, Ullum, H, Rørvig, S B, Tjelle, K, Foss, N B, Benfield, T, Marquart, H V & Plovsing, R R 2020, ' Compartmental immunophenotyping in COVID-19 ARDS : A case series ', Journal of Allergy and Clinical Immunology, vol. 147, no. 1, pp. 81-91 . https://doi.org/10.1016/j.jaci.2020.09.009
- Publication Year :
- 2020
-
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. 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 TH17 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. 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 />Graphical abstract
- Subjects :
- 0301 basic medicine
Male
ARDS
medicine.medical_treatment
CD8-Positive T-Lymphocytes
IP-10, IFN-γ–inducible protein-10
0302 clinical medicine
Immunophenotyping
MCP-1, Monocyte chemoattractant protein-1
Immunology and Allergy
bronchoalveolar lavage
030212 general & internal medicine
PD1, Programmed cell death protein-1
Lung
education.field_of_study
Respiratory Distress Syndrome
COVID-19, Coronavirus disease 2019
medicine.diagnostic_test
Acute respiratory distress syndrome
Middle Aged
RTE, Recent thymic emigrant
ICU, Intensive care unit
medicine.anatomical_structure
Cytokine
CTLA-4, Cytotoxic T lymphocyte–associated protein
Female
Adult
Immunology
Population
Article
03 medical and health sciences
Lymphopenia
ARDS, Acute respiratory distress syndrome
medicine
BALF, Bronchoalveolar lavage fluid
Humans
education
Aged
SARS-CoV-2, Severe acute respiratory syndrome coronavirus 2
business.industry
SARS-CoV-2
Monocyte
flow cytometry
COVID-19
medicine.disease
Treg, Regulatory T
cytokines
030104 developmental biology
Bronchoalveolar lavage
Cross-Sectional Studies
Th17 Cells
business
CD8
Subjects
Details
- ISSN :
- 10976825
- Volume :
- 147
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- The Journal of allergy and clinical immunology
- Accession number :
- edsair.doi.dedup.....2c8d42c13f90658f2ea9cf2dab0a7d45