Increased Th17 and Th22 Cell Percentages Predict Acute Lung Injury in Patients with Sepsis

Lung. 2020 Aug;198(4):687-693. doi: 10.1007/s00408-020-00362-1. Epub 2020 May 27.

Abstract

Purpose: This study was conducted to investigate the percentages of Th22 and Th17 cells in the peripheral blood of septic patients with and without acute lung injury (ALI) and their clinical significance.

Methods: A total of 479 patients were divided into non-ALI and ALI groups. The percentages of Th22 and Th17 cells and the levels of interleukin 22 (IL-22), 6 (IL-6), and 17 (IL-17) were determined. Receiver operating characteristic curve analysis was performed to assess the diagnostic value of Th22 and Th17 cells to predict sepsis-induced ALI.

Results: The lung injury prediction score (LIPS), IL-6, IL-17, and IL-22 levels and the percentages of Th17 and Th22 cells were significantly higher in the ALI group (P < 0.05). They were significant factors affecting sepsis-induced ALI (P < 0.05). Multivariate logistic regression analysis showed that the LIPS (OR = 1.130), IL-17 (OR = 1.982), IL-22 (OR = 2.612) and the percentages of Th17 (OR = 2.211) and Th22 (OR = 3.230) cells were independent risk factors for ALI. The area under the curve of Th22 cells was 0.844 to predict ALI with a cutoff value of 6.81%. The sensitivity and specificity for early diagnosis of sepsis-induced ALI by the Th22 cell percentage were 78.72% and 89.13%, respectively.

Conclusions: Th22 and Th17 cells in peripheral blood are significantly increased in septic patients with ALI and they may be used as biomarkers for early diagnosis of sepsis-induced ALI.

Keywords: Acute lung injury; Interleukin; Sepsis; Th17 cells; Th22 cells.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Lung Injury / blood*
  • Acute Lung Injury / diagnosis
  • Acute Lung Injury / etiology
  • Adult
  • Early Diagnosis
  • Female
  • Humans
  • Interleukin-17 / blood*
  • Interleukin-22
  • Interleukin-6 / blood*
  • Interleukins / blood*
  • Logistic Models
  • Lymphocyte Count
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Sensitivity and Specificity
  • Sepsis / blood*
  • Sepsis / complications
  • T-Lymphocyte Subsets*
  • T-Lymphocytes, Helper-Inducer*
  • Th17 Cells*

Substances

  • IL6 protein, human
  • Interleukin-17
  • Interleukin-6
  • Interleukins