Peripheral blood CD3 and CD4 T-lymphocyte reduction correlates with severity of liver cirrhosis

Abstract

Immunological disturbances with impairment of immune function and a higher incidence of lymphoproliferative disorders and other malignancies have been described in liver cirrhosis patients. To investigate the pathogenetic mechanism(s) involved in such associated we looked for a possible imbalance in peripheral blood T-lymphocyte subpopulations in patients with liver cirrhosis of differing severity. Immunophenotyping and counts of peripheral blood T-lymphocyte subpopulations were carried out using monoclonal antibodies conjugated with different fluorochromes in 31 consecutive cirrhotic patients and 23 matched healthy volunteers. Univariate and multivariate analyses of lymphocyte phenotype counts were performed and odds ratios were computed. Statistically significant associations, according to both univariate and multivariate analyses, were found between case/control status and mean CD3 and CD4 T-lymphocyte counts (P < 0.0001). A strong correlation was found between the Pugh's index and CD3 and CD4 lymphocyte counts, with a clear reduction of these phenotypes with increasing liver cirrhosis. Median CD3 and CD4 values were 2,283 and 1,329/microliters respectively among controls and 896, 801, and 492/microliters and 515, 514, and 307/microliters, respectively in categories A, B, and C of Pugh's classification. Very high odds ratios were found using the median values of CD3 and CD4 as a threshold. There was a statistically significant decrease for each of the T-cell phenotypes studied (CD2, CD3, CD4, CD8, CD16, CD19, CD20, CD56, CD57) between patients and controls (P < 0.0001). The progressive and severity-related decrease in mean peripheral blood CD3 and CD4 counts in liver cirrhosis suggests a progressive impairment of protective immune function and may be a factor facilitating malignancy in cirrhotic patients.

Systemic and Cell-Mediated Immune Response after Laparoscopic and Open Cholecystectomy in Patients with Chronic Liver Disease

“…It is well described that the number of circulating CD3, CD4, CD8, CD16 and CD19 cells are reduced in cirrhotic patients and that concentrations of proinflammatory cytokines increase in correlation to the severity of the liver disease [18, 19, 20]. In this study, however, concentrations of cytokines were the same in the hepatitis and cirrhotic patients, probably due to the relatively small number of patients included.…”

Immune Alterations in Liver Cirrhosis: Its Relationship with Etiology,Child Pugh Stage and Malnutrition

“…The decrease in the total lymphocyte count and the depression in response to the intradermic tests seen in the study and its relation with the severity of the liver damage corresponds with other authors findings [47][48][49][50].…”

Intracranial fungal infections in chronic liver disease: a report of two cases

“…2 The following defences are impaired in cirrhosis leading to increased susceptibility to infections: (i) Liver kupffer cells and sinusoidal endothelial cells (account 90% of reticuloendothelial system); 3 (ii) leukocyte activation, chemotaxis, phagocytosis, cytokine secretion, oxidative burst and microbicidal activity; 4 (iii) peripheral CD4 T-lymphocytes, complement levels, immunoglobulins. [5][6][7] Associated portosystemic shunting, hypersplenism, malnutrition, alcoholism, and immunosuppressive medication [5][6][7] further increase the susceptibility to infections. Additional risk factors predisposing to invasive fungal infections are exposure to broad-spectrum antimicrobials, cancer chemotherapy, indwelling vascular catheters, total parenteral nutrition, prior gastrointestinal surgery, renal failure, haemodialysis, transplantation and diabetes.…”