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First published online on May 19, 2008
Chest, doi:10.1378/chest.07-2626
doi:10.1378/chest.07-2626
(Chest. 2008; 134:483-488)
© 2008 American College of Chest Physicians
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Tc2 Response at the Onset of COPD Exacerbations

Demosthenes Makris, MD*; Stelios Lazarou, MD; Michael Alexandrakis, MD; Taxiarchis V. Kourelis, MD; Nikos Tzanakis, MD; Despina Kyriakou, MD and Kostas I. Gourgoulianis, MD

*From the Departments of Thoracic Medicine (Drs. Makris, Lazarou, and Gourgoulianis) and Hematology (Dr. Kyriakou), University Hospital, Medical School, University of Larisa, Larisa; and Departments of Hematology (Drs. Alexandrakis and Kourelis) and Epidemiology (Dr. Tzanakis), Medical School, University of Crete, Heraklion, Greece.

Correspondence to: Demosthenes Makris, MD, University of Larisa, Medical School, Larisa, Greece; e-mail: appollon7{at}hotmail.com

Abstract

Background:T lymphocytes and especially the subpopulations of CD8+ cells are believed to have a key role in COPD pathophysiology, but there are only few data regarding the role of these cells in COPD exacerbation.

Aim:We aimed to study prospectively changes of CD8+ T-lymphocyte subpopulations in the sputum of COPD patients at the onset of mild exacerbations and at a stable condition in order to provide further insight in the pathophysiology of the disease.

Methods:Induced-sputum samples were collected from 24 COPD patients with median age of 52 years (interquartile range [IQR], 44 to 58 years) and FEV1 percentage of predicted of 78.05% (IQR, 75.8 to 80.1%) at the onset of mild exacerbations not requiring hospitalization and when stable. Inflammatory cells and T-lymphocyte subpopulations (CD4+, CD8+, and cells producing interferon [IFN]-{gamma} or interleukin [IL]-4) were measured using flow cytometry and immunocytochemical methods.

Results:A significant increase in sputum CD8+ T lymphocytes (p < 0.0001) and significant decreases in CD4+ T lymphocytes as well as in CD4+/CD8+ (p = 0.0001) and CD8+IFN-{gamma}+/CD8+IL-4+ (p = 0.001), CD4+IFN-{gamma}+/CD4+IL-4+ (p = 0.0003) sputum cells ratios were found decreased at the onset of exacerbations compared to stable condition. The changes in T-lymphocyte subpopulations were not associated with smoking history, demographic characteristics, or disease severity.

Conclusion:The findings of the present study suggest that CD8+ lymphocytes are increased and potentially polarized toward a Tc2 profile in the airways of COPD patients at the onset of COPD exacerbations with respect to stable condition. The clinical impact of the observed phenomenon requires further investigation.

Key Words: COPD • exacerbations • lymphocytes

Abbreviations: FITC, fluorescein isothiocyanate • IFN, interferon • IL, interleukin • IQR, interquartile range • PE, phycoerythrin • sIFN-{gamma}, supernatant interferon-{gamma} • sIL-4, supernatant interleukin-4 • Th1, T helper type-1






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