New Insights into Blood Circulating Lymphocytes in Human <i>Pneumocystis</i> Pneumonia

The host lymphocyte response is decisive in <i>Pneumocystis</i> pneumonia (PCP) pathophysiology but little is known of the specific roles of lymphocyte subpopulations in this fungal infection. Peripheral NK, NKT, B, TCD4+ and TCD8+ subpopulations were compared by immunophenotyping betwee...

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Bibliographic Details
Main Authors: Eléna Charpentier, Catherine Marques, Sandie Ménard, Pamela Chauvin, Emilie Guemas, Claire Cottrel, Sophie Cassaing, Judith Fillaux, Alexis Valentin, Nicolas Blanchard, Antoine Berry, Xavier Iriart
Format: Article
Language:English
Published: MDPI AG 2021-08-01
Series:Journal of Fungi
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Online Access:https://www.mdpi.com/2309-608X/7/8/652
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Summary:The host lymphocyte response is decisive in <i>Pneumocystis</i> pneumonia (PCP) pathophysiology but little is known of the specific roles of lymphocyte subpopulations in this fungal infection. Peripheral NK, NKT, B, TCD4+ and TCD8+ subpopulations were compared by immunophenotyping between 20 patients diagnosed with PCP (PCP(+)] and 20 uninfected immunosuppressed patients (PCP(−)). Among PCP(+) subjects, the lymphocyte populations were also compared between surviving and deceased patients. Low B cell count (<40 cells/µL) was more frequent in PCP(+) than in PCP(−) patients (<i>p</i> = 0.03), while there was no difference for the TCD4 count. Among the PCP(+) group, the 7 deceased patients had lower Th1 (<i>p</i> = 0.02) and Tc1 (<i>p</i> = 0.03) populations, higher Th2 response (<i>p</i> = 0.03), higher effector TCD8 (<i>p</i> < 0.01), lower central memory TCD8 (<i>p</i> = 0.04) and reduced NK cells (<i>p</i> = 0.02) compared with the 13 survivors. Th1/Th2 ratio < 17, CD8 Tc1 < 44%, effector TCD8 < 25%, central memory TCD8 < 4%, NK cells < 50 cells/µL and total lymphocytes < 0.75 G/L were associated with a higher risk of mortality (<i>p</i> = 0.003, <i>p</i> = 0.007, <i>p</i> = 0.0007, <i>p</i> = 0.004, <i>p</i> = 0.02 and <i>p</i> = 0.019, respectively). The traditional analysis of TCD4 and TCD8 populations may be insufficient in the context of PCP. It could be completed by using B cells to predict the risk of PCP, and by using lymphocyte subpopulations or total lymphocyte count, which are easy to obtain in all health care facilities, to evaluate PCP prognosis.
ISSN:2309-608X