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The TIGIT+ T regulatory cells subset associates with nosocomial infection and fatal outcome in COVID-19 patients under mechanical ventilation
- de Lima, Mikhael Haruo Fernandes;
- Machado, Caio Cavalcante;
- Nascimento, Daniele Carvalho;
- Silva, Camila Meirelles S;
- Toller-Kawahisa, Juliana Escher;
- Rodrigues, Tamara Silva;
- Veras, Flavio Protassio;
- Pontelli, Marjorie Cornejo;
- Castro, Italo A;
- Zamboni, Dario Simões;
- Filho, José-Carlos A;
- Cunha, Thiago M;
- Arruda, Eurico;
- da Cunha, Larissa Dias;
- Oliveira, Renê DR;
- Cunha, Fernando Q;
- Louzada-Junior, Paulo
- et al.
Published Web Location
https://doi.org/10.1038/s41598-023-39924-7Abstract
Abstract: The TIGIT+FOXP3+Treg subset (TIGIT+Tregs) exerts robust suppressive activity on cellular immunity and predisposes septic individuals to opportunistic infection. We hypothesized that TIGIT+Tregs could play an important role in intensifying the COVID-19 severity and hampering the defense against nosocomial infections during hospitalization. Herein we aimed to verify the association between the levels of the TIGIT+Tregs with the mechanical ventilation requirement, fatal outcome, and bacteremia during hospitalization. TIGIT+Tregs were immunophenotyped by flow cytometry from the peripheral blood of 72 unvaccinated hospitalized COVID-19 patients at admission from May 29th to August 6th, 2020. The patients were stratified during hospitalization according to their mechanical ventilation requirement and fatal outcome. COVID-19 resulted in a high prevalence of the TIGIT+Tregs at admission, which progressively increased in patients with mechanical ventilation needs and fatal outcomes. The prevalence of TIGIT+Tregs positively correlated with poor pulmonary function and higher plasma levels of LDH, HMGB1, FGL2, and TNF. The non-survivors presented higher plasma levels of IL-33, HMGB1, FGL2, IL-10, IL-6, and 5.54 times more bacteremia than survivors. Conclusions: The expansion of the TIGIT+Tregs in COVID-19 patients was associated with inflammation, lung dysfunction, bacteremia, and fatal outcome.
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