Changes Of CD39~+Treg In Peripheral Blood Of Patients With Acute Exacerbation Of Chronic Obstructive Pulmonary Disease

Objective:To analyze the variation of CD39~+Regulatory T Lymphocytes Cells and Treg cells in the peripheral blood of patients involved in acute exacerbation of chronic obstructive and stable chronic obstructive pulmonary and study its correlation with systemic inflammatory markers.Method:From March 2018 to December 2018,25 patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD group),25 patients with stable COPD and 25healthy controls were selected as subjects in Liaocheng people’s Hospital.The age,sex,smoking history,white blood cell count,neutrophil percentage,C-reactive protein and procalcitonin were collected.the proportion of CD39~+Treg cells and the proportion of CD4~+CD25~+CD127(low/-)Treg and CD4~+CD39~+T cells to CD4~+T cells in peripheral blood were detected by flow cytometry.Results:(1)There was no significant difference in sex composition and age among AECOPD group,COPD stable group and healthy control group.There was no significant difference in smoking index between AECOPD group and COPD stable group,but white blood cell count,calcitonin and C-reactive protein in AECOPD group were significantly higher than those in COPD stable group and healthy control group(P<0.001).The white blood cell count,procalcitonin and C-reactive protein in AECOPD group were higher than those in COPD stable phase group,and there were statistical differences.The white blood cell count,procalcitonin and C-reactive protein in COPD stable group were higher than those in healthy control group,but there was no statistical difference.(2)The proportion of Treg cells in peripheral blood of AECOPD group was significantly higher than that of COPD stable group and healthy control group.The proportion of Treg cells in peripheral blood of patients with stable),COPD was significantly higher than that of healthy controls(P<0.001),but there was no significant difference between the two groups(P≥0.845).The proportion of CD39~+Treg cells in peripheral blood of AECOPD group was significantly higher than that of COPD stable group and healthy control group.The difference was statistically significant(P<0.001).The proportion of CD39~+Treg cells in healthy control group was higher than that in COPD stable group,and the difference was statistically significant(P<0.001);AECOPD group,the proportion of CD4~+CD39~+cells in peripheral blood of patients in COPD stable group was significantly higher than that in COPD stable group.The proportion of CD4~+CD39~+cells in peripheral blood of patients with P≥0.001),AECOPD was significantly higher than that of healthy controls,but there was no significant difference(P≥0.090).The proportion of CD4~+CD39~+cells in healthy control group was higher than that in COPD stable group,but there was no significant difference(P≥0.0725).(3)There was no significant correlation between Treg cells and smoking index,white blood cell count and procalcitonin in COPD acute exacerbation group,but there was a positive correlation between Treg cells and the concentration of C-reactive protein(r≥0.629,P≤0.001).There was no significant correlation between the proportion of CD4~+CD39~+cells and smoking index,white blood cell count,calcitonin and C-reactive protein in COPD acute exacerbation group.There was no significant correlation between the proportion of CD39~+Treg cells and smoking index,white blood cell count,calcitonin and C-reactive protein in COPD acute exacerbation group.Conclusion:1.In AECOPD group,not only the proportion of Treg cells in peripheral blood increased,but also the proportion of CD39+Treg cells increased.2.The decrease of CD39~+Treg cells in peripheral blood of patients with stable 2.COPD may lead to the increase of extracellular ATP,which may affect the progression of the disease.3.The increased expression of CD39~+Treg cells in peripheral blood of 3.AECOPD patients may be related to the enhancement of systemic inflammatory response in the acute exacerbation of COPD.