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The Roles of Programed Death-1, Regulatory T Cells and Myeloid Derived Suppressor Cells in Patients with Mycobacterium Avium Complex- or Mycobacterium Abscessus-Lung Disease
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A4302 - The Roles of Programed Death-1, Regulatory T Cells and Myeloid Derived Suppressor Cells in Patients with Mycobacterium Avium Complex- or Mycobacterium Abscessus-Lung Disease
Author Block: C. Shu; Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Background: Nontuberculous mycobacteria lung disease (NTN-LD) has become a clinical concern due to its increasing prevalence in recent decades. Although immune tolerance in NTM-LD patients has been reported, its role in clinical characteristics and outcomes remains uncertain. Methods: We enrolled 96 participants from two medical centers in Taiwan, including 46 with Mycobacterium avium complex (MAC)-LD, 23 with M. abscessus (MAB)-LD, and 27 controls. We measured expressions of programmed death-1 (PD-1), cytotoxic T-lymphocyte antigen-4 (CTLA-4) and regulatory T (Treg) cells on CD4+ lymphocytes and myeloid-derived suppressor cells (MDSCs) and analyzed their association with clinical features and radiographic outcomes. Results: The percentage of PD-1 on CD4+ (PD-1+CD4+) lymphocytes was higher in the MAC-LD group, and the MAC-LD and MAB-LD groups had higher levels of MDSCs than the controls. There were no intergroup differences in the expression of CTLA-4 on CD4+ lymphocytes and Treg cells. Higher percentages of PD-1+CD4+ lymphocytes were found in M. intracellulare- and M. avium-LD than in other MAC-LD. Positive sputum acid fast stains and fibrocavitary radiographic lesions were correlated with elevated expressions of PD-1+CD4+ lymphocytes and Treg cells but not MDSCs. The percentage of PD-1+CD4+ lymphocytes significantly predicted radiographic progression. At 2 months of follow-up, the percentages of PD-1+CD4+ lymphocytes and MDSCs were associated with subsequent radiographic progression. Conclusion: As markers of immune tolerance, PD-1+CD4+ lymphocytes increased in patients with MAC-LD, and MDSCs increased in both patients with MAC-LD and MAB-LD. The levels of PD-1+CD4+ and Treg cells were correlated with high mycobacteria bacilli burden in NTM-LD. Monitoring the expressions of PD-1+CD4+ lymphocytes and MDSCs may predict radiographic progression and outcomes.
Author Block: C. Shu; Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Background: Nontuberculous mycobacteria lung disease (NTN-LD) has become a clinical concern due to its increasing prevalence in recent decades. Although immune tolerance in NTM-LD patients has been reported, its role in clinical characteristics and outcomes remains uncertain. Methods: We enrolled 96 participants from two medical centers in Taiwan, including 46 with Mycobacterium avium complex (MAC)-LD, 23 with M. abscessus (MAB)-LD, and 27 controls. We measured expressions of programmed death-1 (PD-1), cytotoxic T-lymphocyte antigen-4 (CTLA-4) and regulatory T (Treg) cells on CD4+ lymphocytes and myeloid-derived suppressor cells (MDSCs) and analyzed their association with clinical features and radiographic outcomes. Results: The percentage of PD-1 on CD4+ (PD-1+CD4+) lymphocytes was higher in the MAC-LD group, and the MAC-LD and MAB-LD groups had higher levels of MDSCs than the controls. There were no intergroup differences in the expression of CTLA-4 on CD4+ lymphocytes and Treg cells. Higher percentages of PD-1+CD4+ lymphocytes were found in M. intracellulare- and M. avium-LD than in other MAC-LD. Positive sputum acid fast stains and fibrocavitary radiographic lesions were correlated with elevated expressions of PD-1+CD4+ lymphocytes and Treg cells but not MDSCs. The percentage of PD-1+CD4+ lymphocytes significantly predicted radiographic progression. At 2 months of follow-up, the percentages of PD-1+CD4+ lymphocytes and MDSCs were associated with subsequent radiographic progression. Conclusion: As markers of immune tolerance, PD-1+CD4+ lymphocytes increased in patients with MAC-LD, and MDSCs increased in both patients with MAC-LD and MAB-LD. The levels of PD-1+CD4+ and Treg cells were correlated with high mycobacteria bacilli burden in NTM-LD. Monitoring the expressions of PD-1+CD4+ lymphocytes and MDSCs may predict radiographic progression and outcomes.
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