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Journal of Translational Medicine
Published in: Journal of Translational Medicine 1/2020

Open Access 01-12-2020 | Bronchoscopy | Research

Bronchoalveolar Tregs are associated with duration of mechanical ventilation in acute respiratory distress syndrome

Authors: Dustin L. Norton, Agathe Ceppe, Miriya K. Tune, Matthew McCravy, Thomas Devlin, M. Bradley Drummond, Shannon S. Carson, Benjamin G. Vincent, Robert S. Hagan, Hong Dang, Claire M. Doerschuk, Jason R. Mock

Published in: Journal of Translational Medicine | Issue 1/2020

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Abstract

Background

Foxp3+ regulatory T cells (Tregs) play essential roles in immune homeostasis and repair of damaged lung tissue. We hypothesized that patients whose lung injury resolves quickly, as measured by time to liberation from mechanical ventilation, have a higher percentage of Tregs amongst CD4+ T cells in either airway, bronchoalveolar lavage (BAL) or peripheral blood samples.

Methods

We prospectively enrolled patients with ARDS requiring mechanical ventilation and collected serial samples, the first within 72 h of ARDS diagnosis (day 0) and the second 48–96 h later (day 3). We analyzed immune cell populations and cytokines in BAL, tracheal aspirates and peripheral blood, as well as cytokines in plasma, obtained at the time of bronchoscopy. The study cohort was divided into fast resolvers (FR; n = 8) and slow resolvers (SR; n = 5), based on the median number of days until first extubation for all participants (n = 13). The primary measure was the percentage of CD4+ T cells that were Tregs.

Results

The BAL of FR contained more Tregs than SR. This finding did not extend to Tregs in tracheal aspirates or blood. BAL Tregs expressed more of the full-length FOXP3 than a splice variant missing exon 2 compared to Tregs in simultaneously obtained peripheral blood.

Conclusion

Tregs are present in the bronchoalveolar space during ARDS. A greater percentage of CD4+ cells were Tregs in the BAL of FR than SR. Tregs may play a role in the resolution of ARDS, and enhancing their numbers or functions may be a therapeutic target.
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Metadata
Title
Bronchoalveolar Tregs are associated with duration of mechanical ventilation in acute respiratory distress syndrome
Authors
Dustin L. Norton
Agathe Ceppe
Miriya K. Tune
Matthew McCravy
Thomas Devlin
M. Bradley Drummond
Shannon S. Carson
Benjamin G. Vincent
Robert S. Hagan
Hong Dang
Claire M. Doerschuk
Jason R. Mock
Publication date
01-12-2020
Publisher
BioMed Central
Published in
Journal of Translational Medicine / Issue 1/2020
Electronic ISSN: 1479-5876
DOI
https://doi.org/10.1186/s12967-020-02595-3

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