Decreased CD8+CD28+/CD8+CD28– T cell ratio can sensitively predict poor outcome for patients with complicated Crohn disease
Dai, Shi-xue; Gu, Hong-xiang; Lin, Qian-yi; Wu, Yan-kun; Wang, Xiao-yan; Huang, Shao-zhuo; Xing, Tiao-si; Chen, Min-hua; Zhang, Qing-fang; Zheng, Zhong-wen; Sha, Wei-hong
Crohn disease (CD) with complications such as penetrating, stricturing, and perianal disease is called complicated CD. The aim of this study is to test the efficiency with which the CD8+CD28+/CD8+CD28– cell balance can predict a subsequent active stage in patients with newly diagnosed complicated CD. Seventeen patients with complicated CD and 48 CD patients with no complications were enrolled. Blood CD8+ T cells were tested from all of the 65 newly diagnosed CD patients upon enrollment. The potential risk factors were compared between the 2 groups. A 30-week follow-up was performed, and the efficiency of the CD8+ cell balance at predicting active CD was analyzed using receiver- operating characteristic curves. The cumulative remission lasting rates (CRLRs) were analyzed using the Kaplan–Meier method. Compared with the control CD group, patients with complicated CD were predominantly male and younger in age; they also had lower body mass indices (BMIs), higher Crohn disease activity indices (CDAIs), higher immunosuppressant and steroid prescription rates, and significantly higher surgical rates. The CD8+CD28+/CD8+CD28– balance was associated with BMI, CDAI, steroids, and surgery. The CD8+CD28+/CD8+CD28– ratios were significantly lower at week 0 and on the 6th, 22nd, and 30th week during follow- up with a shorter lasting time of remission for the complicated CD patients. The CD8+CD28+/CD8+CD28– ratio could accurately predict the active stage for the patients with complicated CD, and the highest sensitivity (89.2%) and specificity (85.3%) were found when the ratio was 1.03. Treatment with steroids and surgery, along with a significantly lower CD8+CD28+/CD8+CD28– ratio and lower CRLRs, was closely related to a worse outcome for the patients with complicated CD. Patients requiring steroids and surgery experience more severe disease activity and thus a disequilibrated immunological balance, which could be the main reason for a decreased CD8+CD28+/CD8+CD28– ratio. This ratio can sensitively predict the active stage for patients with complicated CD, and more care should be taken when this ratio is <1.03.
Dai, Shi-xue, & Gu, Hong-xiang, & Lin, Qian-yi, & Wu, Yan-kun, & Wang, Xiao-yan, & Huang, Shao-zhuo, & Xing, Tiao-si, & Chen, Min-hua, & Zhang, Qing-fang, & Zheng, Zhong-wen, & Sha, Wei-hong. (June 2017). Decreased CD8+CD28+/CD8+CD28– T cell ratio can sensitively predict poor outcome for patients with complicated Crohn disease. Medicine, (96:26), p.. Retrieved from http://hdl.handle.net/10342/8151
Dai, Shi-xue, and Gu, Hong-xiang, and Lin, Qian-yi, and Wu, Yan-kun, and Wang, Xiao-yan, and Huang, Shao-zhuo, and Xing, Tiao-si, and Chen, Min-hua, and Zhang, Qing-fang, and Zheng, Zhong-wen, and Sha, Wei-hong. "Decreased CD8+CD28+/CD8+CD28– T cell ratio can sensitively predict poor outcome for patients with complicated Crohn disease". Medicine. 96:26. (.), June 2017. September 23, 2020. http://hdl.handle.net/10342/8151.
Dai, Shi-xue and Gu, Hong-xiang and Lin, Qian-yi and Wu, Yan-kun and Wang, Xiao-yan and Huang, Shao-zhuo and Xing, Tiao-si and Chen, Min-hua and Zhang, Qing-fang and Zheng, Zhong-wen and Sha, Wei-hong, "Decreased CD8+CD28+/CD8+CD28– T cell ratio can sensitively predict poor outcome for patients with complicated Crohn disease," Medicine 96, no. 26 (June 2017), http://hdl.handle.net/10342/8151 (accessed September 23, 2020).
Dai, Shi-xue, Gu, Hong-xiang, Lin, Qian-yi, Wu, Yan-kun, Wang, Xiao-yan, Huang, Shao-zhuo, Xing, Tiao-si, Chen, Min-hua, Zhang, Qing-fang, Zheng, Zhong-wen, Sha, Wei-hong. Decreased CD8+CD28+/CD8+CD28– T cell ratio can sensitively predict poor outcome for patients with complicated Crohn disease. Medicine. June 2017; 96(26) . http://hdl.handle.net/10342/8151. Accessed September 23, 2020.