학술논문
The TIGIT+ T regulatory cells subset associates with nosocomial infection and fatal outcome in COVID-19 patients under mechanical ventilation
Document Type
article
Author
de Lima, Mikhael Haruo Fernandes; Machado, Caio Cavalcante; Nascimento, Daniele Carvalho; Silva, Camila Meirelles S; Toller-Kawahisa, Juliana Escher; Rodrigues, Tamara Silva; Veras, Flavio Protassio; Pontelli, Marjorie Cornejo; Castro, Italo A; Zamboni, Dario Simões; Filho, José-Carlos A; Cunha, Thiago M; Arruda, Eurico; da Cunha, Larissa Dias; Oliveira, Renê DR; Cunha, Fernando Q; Louzada-Junior, Paulo
Source
Scientific Reports. 13(1)
Subject
Language
Abstract
Abstract: The TIGIT+FOXP3+Treg subset (TIGIT+Tregs) exerts robust suppressive activity on cellular immunity and predisposes septic individuals to opportunistic infection. We hypothesized that TIGIT+Tregs could play an important role in intensifying the COVID-19 severity and hampering the defense against nosocomial infections during hospitalization. Herein we aimed to verify the association between the levels of the TIGIT+Tregs with the mechanical ventilation requirement, fatal outcome, and bacteremia during hospitalization. TIGIT+Tregs were immunophenotyped by flow cytometry from the peripheral blood of 72 unvaccinated hospitalized COVID-19 patients at admission from May 29th to August 6th, 2020. The patients were stratified during hospitalization according to their mechanical ventilation requirement and fatal outcome. COVID-19 resulted in a high prevalence of the TIGIT+Tregs at admission, which progressively increased in patients with mechanical ventilation needs and fatal outcomes. The prevalence of TIGIT+Tregs positively correlated with poor pulmonary function and higher plasma levels of LDH, HMGB1, FGL2, and TNF. The non-survivors presented higher plasma levels of IL-33, HMGB1, FGL2, IL-10, IL-6, and 5.54 times more bacteremia than survivors. Conclusions: The expansion of the TIGIT+Tregs in COVID-19 patients was associated with inflammation, lung dysfunction, bacteremia, and fatal outcome.