The Relationship Between Apoptosis Of T Lymphocyte Subsets And The Expession Of Fas, FasL, Bcl-2 In Patients With COPD And The Effect Of Malnutrition

Objective:Apoptosis has played an important role in the pathogenesis of COPD. This study detected the apoptosis of peripheral blood T lymphocyte subsets CD4+, CD8+ T cell and the expression of antigen Fas, FasL, Bcl-2 on their surface in patients with acute exacerbation of COPD, stable COPD and normal,then to discuss the relationship among T Lymphocyte apoptosis and the antigen expression and nutritional status.Methods:In this study,we choose 30 patients with COPD and collect peripheral blood in both the acute and stable stage,to verify the apoptosis rate of T lymphocyte subsets and the expression of antigen Fas, FasL, Bcl-2 on their surface by flow cytometry, we also measure pulmonary function and assess the nutritional status.Finally, we choose 20 cases of normal-control group to compare with the certain status mentioned above.Results:1. When compared with normal-control group, the expressions of CD4+ apoptosis are both increased, while expressions of CD8+apoptosis are both decreased, the results are significant statistics (P<0.05); When compared with patients with stable COPD, those in acute stage have higher expression level in the apoptosis of CD4+, while have lower expression level in the apoptosis of CD8+, this results are significant statistics (P<0.05).2. When compared with normal-control group, the acute and stable COPD have higher expression level in the antigen CD4+Fas, CD4+ FasL, while have lower expression of CD4+Bcl-2, the results are significant statistics (P<0.05). When compared with patients with stable COPD, the results are the same in both stage. There was a positive correlation between apoptosis of CD4+ and the lever of CD4+Fas, CD4+ FasL, and had a negative correlation with the CD4+Bcl-2 expression respectively in exacerbated and stable COPD.3. When compared with normal-control group, expressions of the antigen CD8+Fas, CD8+FasL are both increased, the results are significant statistics (P<0.05).When compared with stable COPD group, those in acute stage have a higher expression level in the antigen CD8+Fas, CD8+ FasL, the results are significant statistics (P<0.05).The expression of CD8+ Bcl-2 has no significant statistics among the three groups. The was no correlation between apoptosis of CD8+ and CD8+Fas, CD8+FasL and CD8 +Bcl-2.4. When compared with normal-control group, those with nutrition normal and malnourished COPD have higher expression level in the antigen CD4+Fas, CD4+ FasL and the apoptosis of CD4+, while have lower expression of CD4+ Bcl-2, the results are significant statistics (P<0.05);When compared with nutrition normal COPD, those with malnourished COPD have a higher expression level in apoptosis of CD8+and the antigen CD4+Fas, CD4+FasL, the results are significant statistics (P<0.05).The expression of apoptosis of CD8+ and antigen CD8+Fas, CD8+FasL and CD8 +Bcl-2 has no significant statistics in two groups with COPD.The was positive correlation between body mass index and apoptosis of CD4+, CD4+Fas andCD4+FasL, and had a negative correlation with CD4+Bcl-2 expression respectively in the sernu of stable COPD; The was no correlation between body mass index and apoptosis of CD8+ and CD8+Fas, CD8+FasL and CD8+ Bcl-2.Conclusion:1.The increased apoptosis of CD4+and decreased apoptosis of CD8+ suggest that the apoptosis of T lymphocyte is participated the occurrence and development of COPD.2.Expression of CD4+Fas and CD4+FasL in patients with acute and stable COPD is positive correlation to apoptosis of CD4+,while the decreased expression of CD4+Bcl-2 is negative correlation to apoptosis of CD4+,which suggest that the apoptosis pathway Fas/FasL, Bcl-2 play an important role in the occurrence of CD4+ in patients with COPD.The increseased apoptosis of CD4+ lead to the decreased immunity.3.The increased of Fas/ FasL on the surface of CD8+in patients with COPD,has no relation with the decreased expression of CD4+which suggest the Fas/ FasL is not the main pathway in which CD8+T c apoptosis,this is so complex that is need to be futher researched.4.In patients with malnutrition, CD4+apoptosis increased,while the numbers of CD4+decreased,and the rate of them decreased,what is more,in patients with COPD with malnutrition expression of CD4+Fas,CD4+FasL increased,while that of CD4+Bcl-2 decreased,which is related to the apoptosis of CD4+,suggesting that malnutrition improve the apoptosis of T Lymphocyte in COPD.