Expression and Significance of Th17 and Treg Cells in Pulmonary Infections with Gram-Negative Bacteria

Liu, Ying; Sun, Jianfang; Xiang, Qi; Chen, Yongming; Li, Jing; Chen, Shangyu; Han, Lei

doi:10.1080/08820139.2017.1360338

Cited by 8 publications

(8 citation statements)

References 28 publications

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“…Interestingly, a reduction in T H 17 cells in VAP patients in comparison to ventilated patients who did not develop pneumonia has been reported in one study [16]. Another study found the opposite [15]. While the precise reasons for this discrepancy is unknown, in acute infections and therefore in absence of an adaptive immune response, the numbers of T H cells should not be expected to change.…”

Section: Discussionmentioning

confidence: 96%

“…However, published data on IL-17/IL-22 in MV or VAP are conflicting. One study on ventilated patients showed that T H 17 cells were increased both in the peripheral blood and in the lung in VAP patients compared to ventilated patients who did not develop pneumonia [15]. In contrast, another study on ventilated patients showed a reduced number of T H 17 cells in lung lavage fluid of VAP patients compared to those who did not develop VAP, suggesting that T H 17 cells were protective against VAP [16].…”

Section: Introductionmentioning

confidence: 99%

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Mechanical Ventilation Impairs IL-17 Cytokine Family Expression in Ventilator-Associated Pneumonia

Winter

Jongers

Bielen

et al. 2019

IJMS

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Mechanical ventilation (MV) is the primary risk factor for the development of ventilator-associated pneumonia (VAP). Besides inducing a pro-inflammatory T-helper (Th)-1 cytokine response, MV also induces an anti-inflammatory Th2 cytokine response, marked by increased IL-4 secretion and reduced bacterial phagocytic capacity of rodent lung macrophages. Since IL-4 is known to downregulate both Th1 and Th17 cytokines, the latter is important in mediating mucosal immunity and combating bacterial and fungal growth, we studied and showed here in a rat model of MV that Th17 cytokines (IL-17A, IL-17F, and IL-22) were significantly upregulated in the lung as a response to different MV strategies currently utilized in clinic. To study whether the increased IL-4 levels are associated with downregulation of the anti-bacterial Th17 cytokines, we subsequently challenged mechanically ventilated rats with an intratracheal inoculation of Pseudomonas aeruginosa (VAP model) and showed a dramatic downregulation of IL-17A, IL-17F, and IL-22, compared to animals receiving the same bacterial burden without MV. For the studied Th1 cytokines (IFNγ, TNFα, IL-6, and IL-1β), only IFNγ showed a significant decrease as a consequence of bacterial infection in mechanically ventilated rats. We further studied IL-17A, the most studied IL-17 family member, in intensive care unit (ICU) pneumonia patients and showed that VAP patients had significantly lower levels of IL-17A in the endotracheal aspirate compared to patients entering ICU with pre-existing pneumonia. These translational data, obtained both in animal models and in humans, suggest that a deficient anti-bacterial Th17 response in the lung during MV is associated with VAP development.

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Section: Discussionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

Mechanical Ventilation Impairs IL-17 Cytokine Family Expression in Ventilator-Associated Pneumonia

Winter

Jongers

Bielen

et al. 2019

IJMS

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“…Our results also showed that patients who received EEN required a shorter duration of mechanical ventilation and had shorter lengths of ICU stay and hospital stay than those who received DEN, indicating that EEN shortens the duration of mechanical ventilation and the lengths of ICU stay and hospital stay more significantly than DEN; this agrees with the findings of previous studies. 1,2,5 The ET levels in peripheral venous blood were high in both groups before treatment, but they were prominently decreased by enteral nutrition treatment, especially by EEN, indicating that EEN therapy can promote the recovery of gastrointestinal function, stabilize the intestinal flora, and inhibit intestinal flora and ET translocation, which helps to reduce secondary infections in patients with sepsis.…”

Section: Discussionmentioning

confidence: 94%

“…1 Our previous studies showed that there are excessive immune responses such as increased proportions of Th17 cells and Treg cells and decreased Treg/Th17 ratio in patients with sepsis caused by gram-negative bacilli in the lungs. 2 Nutritional therapy has become an important therapeutic measure for patients with sepsis. Enteral nutrition improves intestinal mucosal barrier function, promotes intestinal mucosal repair, and stabilizes intestinal flora.…”

Section: Introductionmentioning

confidence: 99%

Effects of Early Enteral Nutrition on Immune Function and Prognosis of Patients With Sepsis on Mechanical Ventilation

Liu

Zhao

Chen

et al. 2018

J Intensive Care Med

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Objective: To explore the therapeutic effects of early enteral nutrition (EEN) on patients with sepsis on mechanical ventilation. Methods: Patients with sepsis on mechanical ventilation in the medical intensive care unit (ICU) from January 2013 to March 2016 were treated with enteral nutrition. Patients treated within 48 hours of initiation of mechanical ventilation were assigned to the EEN group, and the rest were assigned to the delayed enteral nutrition (DEN) group. Peripheral blood Th17 cells and Treg cells, endotoxin (ET) level, 28-day mortality, duration of mechanical ventilation, lengths of ICU stay and hospital stay, and incidence of ICU-acquired weakness (ICU-AW) were analyzed between the 2 groups. Results: The proportion of Th17 cells and ET levels in the EEN group were significantly lower than those in the DEN group, whereas the proportion of Treg cells in the EEN group was remarkably higher than that in the DEN group ( P < .05). The duration of mechanical ventilation, lengths of ICU stay and hospital stay, and incidence of ICU-AW were higher in the DEN group than in the EEN group ( P < .05), but there was no significant difference in the 28-day mortality between the 2 groups. Conclusion: Patients with sepsis mainly present with an increased proportion of Th17 cells in the early stage, manifesting as enhanced immune response. Early enteral nutrition can inhibit the excessive immune response, shorten the duration of mechanical ventilation, lengths of ICU stay and hospital stay, and reduce the incidence of ICU-AW, but it has no obvious effect on 28-day mortality.

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“…Patients with severe pulmonary infections have limited systemic activity and reduced ability to excrete sputum independently, which can result in thick sputum and the accumulation of secretions, and thus increases the risk of airway blockage (10,11). Studies have shown that the treatment of severe pulmonary infections should focus on fighting the infection, removing foreign bodies in the respiratory tract, and ensuring that the respiratory tract is clear of blockages (12).…”

Section: Discussionmentioning

confidence: 99%

A randomised trial on the therapeutic effectiveness of bronchoalveolar lavage under fiberoptic bronchoscopy in patients with severe lung infection living in the Tibetan plateau area

Zhou

Liu

et al. 2021

Ann Palliat Med

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Background: People living in plateau areas are prone to upper respiratory tract infections and secondary lung infections. The current study aimed to explore the effects of bronchoalveolar lavage under fiberoptic bronchoscope for the treatment of patients with severe pulmonary infection living in plateau areas.Methods: 148 patients with severe lung infection admitted to the intensive care unit of Shigatse People's Hospital (Shigatse, Tibet Autonomous Region, China) between July 2019 and January 2021 were enrolled.Patients were randomly assigned to the observational group or the control group. For all patients, basic clinical data including sex, age, body mass index (BMI), blood pressure, diabetes history, stroke history, presence or absence of chronic obstructive pulmonary disease, lung infection (gram-positive bacterial infection, gram-negative bacterial infection, fungal infection, acute lung abscess), surgical history, and postoperative inhalation injury. were collected. The control group received conventional treatment, and the observational group received bronchoalveolar lavage under fiberoptic bronchoscopy. Pearson's correlation was used to analyze the correlations between bronchoalveolar lavage under fiberoptic bronchoscopy and inflammatory factors levels. Logistic regression was used to investigate the correlation between bronchoalveolar lavage under fiberoptic bronchoscopy and the effectiveness of the treatment.Results: Before treatment, no significant difference existed in the basic data of the observational group and the control group. After treatment, the parameters of respiratory mechanics and inflammatory factors in the 2 groups were significantly improved compared with those before treatment (P<0.05). At the same time, in the observational group, the clinical parameters were significantly higher than those of the control group, and the levels of inflammatory factors were significantly lower than those of the control group (all P<0.05).After full adjustment for age, sex, BMI, gram-negative infection, diabetes, and acute lung abscess, compared with the control group, the therapeutic effectiveness in the observational group was increased by 23% (OR =1.23, 95% CI: 1.09-1.51, P=0.007).Conclusions: For patients with severe lung infection who are resident in high altitude areas, compared with conventional treatments, bronchoalveolar lavage under fiberoptic bronchoscopy can significantly improve chest, lung, and total dynamic compliance, as well as reduce the levels of the inflammatory factors procalcitonin (PCT) and transforming growth factor-β, thus increasing the effectiveness of the treatment.

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Expression and Significance of Th17 and Treg Cells in Pulmonary Infections with Gram-Negative Bacteria

Cited by 8 publications

References 28 publications

Mechanical Ventilation Impairs IL-17 Cytokine Family Expression in Ventilator-Associated Pneumonia

Mechanical Ventilation Impairs IL-17 Cytokine Family Expression in Ventilator-Associated Pneumonia

Effects of Early Enteral Nutrition on Immune Function and Prognosis of Patients With Sepsis on Mechanical Ventilation

A randomised trial on the therapeutic effectiveness of bronchoalveolar lavage under fiberoptic bronchoscopy in patients with severe lung infection living in the Tibetan plateau area

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