Increased cytotoxic T-cells in the airways of adults with former bronchopulmonary dysplasia

Abstract

RationaleBronchopulmonary Dysplasia (BPD) in preterm born infants is a risk factor for chronic airway obstruction in adulthood. Cytotoxic T-cells are implicated in chronic obstructive pulmonary disease (COPD), but their involvement in BPD is not known.ObjectivesTo characterise the distribution of airway T-cell subsets in adults with a history of BPD.MethodsYoung adults with former BPD (n=22; median age 19.6 years), age-matched adults born preterm (n=22), patients with allergic asthma born at term (n=22), and healthy control subjects born at term (n=24) underwent bronchoalveolar lavage (BAL). T-cell subsets in BAL were analysed using flow cytometry.ResultsThe total number of cells and the differential cell counts in BAL were similar among the study groups. The percentage of CD3+CD8+T-cells was higher (p=0.005) and the proportion of CD3+CD4+T-cells was reduced (p=0.01) in the BPD group, resulting in a lower CD4/CD8 ratio (p=0.007) compared to the healthy controls (median 2.2 versus 5.3). In BPD and preterm born study subjects, both CD3+CD4+T cells (rs=0.38, p=0.03) and CD4/CD8 ratio (rs=0.44, p=0.01) correlated positively with FEV1. Further, CD3+CD8+T-cells were negatively correlated with both FEV1 and FEV1/FVC (rs=−0.44, p=0.09 and rs=−0.41, p=0.01, respectively).ConclusionsYoung adults with former BPD have a T-cell subset pattern in the airways resembling features of COPD. Our findings are compatible with the hypothesis that CD3+CD8+T-cells are involved in mechanisms behind chronic airway obstruction in these patients.

CD8A is a Promising Biomarker Associated with Immunocytes Infiltration in Hyperoxia-Induced Bronchopulmonary Dysplasia

“…1,2 Approximately 10-30% premature infants who were born with <1000 g birthweight before 30 weeks' gestation would have the potential to develop BPD. 3 Mounting evidences have demonstrated that BPD is associated with considerable morbidity and mortality in the newborn period, childhood, and adulthood. 4,5 In addition to the respiratory system, BPD also shows adverse impacts on the neurodevelopment and other organs throughout the body.…”

Reply to Guo et al.

“…This approach captures participants moving from relatively low-risk to high-risk subgroups of future diseases, such as chronic obstructive pulmonary disease. As highlighted by Guo and colleagues, and also discussed elsewhere ( 5 ), this highlights the importance of taking the heterogeneity of processes that can lead to chronic airway obstruction into account (e.g., bronchopulmonary dysplasia after preterm birth as one specific example) ( 6 ). Whether the growth failure group will experience the same (or different) lung aging process as the persistently low group needs to be explored in future studies ( 7 ).…”

Prematurity and BPD: what general pediatricians should know

“…The chronic inflammation in BPD subjects [43,44], and the normal levels of FeNO (a marker of eosinophilic inflammation) in children born preterm suggest that the inflammatory mechanisms in their airways differ from the eosinophilic inflammation of childhood asthma, raising questions over the long-term use of inhaled corticosteroids for BPD patients [45]. Research on the efficacy of these drugs in preterm-born children is still ongoing [46], but there is still no evidence to support their background use [47].…”