Early change in peripheral CD4+ T cells associated with clinical outcomes of immunotherapy in gastrointestinal cancer

Biomarkers for immune checkpoint inhibitors (ICIs) are limited in gastrointestinal cancer. Peripheral blood lymphocyte subset and associated dynamic changes were retrospectively analyzed in patients with gastrointestinal cancer treated with ICIs. Cox regression and Kaplan-Meier analyses were conducted for survival. A total of 80 patients were enrolled. Baseline CD4+/CD8+ T cells were lower in patients who experienced tumor progression by 6 months than in patients who did not (1.160 ± 0.652 vs 1.705 ± 0.924, respectively; p = 0.003). In multivariate analyses, decline in CD4+ T cells after the first dose of ICIs (CD4-C1-decline) was an independent prognostic factor for overall survival (hazard ratio: 13.00; 95% CI: 2.24–75.54; p = 0.004). Furthermore, CD4-C1-decline was a preferable indicator for progression in patients with deficient mismatch repair/microsatellite instability-high (p = 0.027). Early change in CD4+ T cell counts in peripheral blood may act as a prognostic biomarker for gastrointestinal cancer patients treated with ICIs.

Dynamic Changes in Serum Cortisol and Acth Levels and Lymphocyte Subset Counts in Children With Septic Shock

Backgroud: To study the dynamic changes in serum cortisol, adrenocorticotropic hormone (ACTH) levels and peripheral blood lymphocyte subset counts in children with septic shock (SS) and to explore their association with the severity and prognosis of the disease. Methods: The levels of serum cortisol, ACTH and peripheral blood lymphocyte subsets were analyzed in 25 patients in the advanced-stage group with decreased blood pressure and 24 patients in the early-stage group with normal blood pressure. Twenty-five healthy children who underwent physical examination were selected as the control group. Children in the advanced-stage group were further divided into the death subgroup (n = 5) and the survival subgroup (n = 20).Results: At admission, the levels of serum cortisol and ACTH in the advanced-stage group were apparently higher than those in the early-stage group (P < 0.05). The advanced-stage group had significantly lower lymphocyte subset counts than the early-stage group (P < 0.05). On the 3rd day after admission, the levels of serum cortisol and ACTH in both groups decreased, and the counts of total lymphocytes, T cells and Th cells in the early-stage group were significantly higher than those at admission. On the 8th day after admission, there was no statistically significant difference in the levels of serum cortisol or ACTH between the groups. At admission, there was no statistically significant difference in serum cortisol and ACTH levels between the death subgroup and the survival subgroup. On the third day after admission, the levels of cortisol and ACTH were decreased in both groups, but the differences between the two subgroups were not statistically significant. All the lymphocyte subset counts in the death subgroup on the third day after admission were significantly lower than those in the survival subgroup (P < 0.05).Conclusions: The hypothalamic-pituitary-adrenal axis is excessively activated in children with SS. Higher serum cortisol and ACTH levels and lower peripheral blood lymphocyte subset counts indicate increased severity of the disease. After treatment, the first signs that indicate the effective control of the disease are decreased serum cortisol and ACTH levels and increased T cell, Th cell and total lymphocyte counts.

Effect of montelukast combined with methylprednisolone for the treatment of mycoplasma pneumonia

Objective To study the effect of the leukotriene receptor agonist montelukast combined with methylprednisolone on inflammatory response and peripheral blood lymphocyte subset content in children with mycoplasma pneumonia. Methods Seventy-four children were enrolled and randomly divided into a standard treatment group and a montelukast plus methylprednisolone group. Serum levels of inflammatory cytokines and corresponding cytokines of T lymphocyte subsets were measured, and peripheral blood was collected to determine the T cell subset content. Results At 3 days and 7 days after treatment, serum MCP-1, PCT, ICAM-1, CXCL8, CRP, IFN-γ, and IL-17 levels and peripheral blood Th1 and Th17 content were significantly decreased in both groups, while serum IL-4 and TGF-β levels and peripheral blood Treg and Th2 content were significantly increased. However, serum MCP-1, PCT, ICAM-1, CXCL8, CRP, IFN-γ, and IL-17 levels and peripheral blood Th1 and Th17 content were significantly lower while serum IL-4 and TGF-β levels and peripheral blood Treg and Th2 content were significantly higher in the montelukast plus methylprednisolone group compared with the control group. Conclusion Montelukast combined with methylprednisolone for the treatment of mycoplasma pneumonia can inhibit inflammatory responses and regulate levels of Th1/Th2 and Th17/Treg cells.