Contribution of CD4+ T Cell-mediated Inflammation to Diarrhea in Patients with COVID-19

Overview

Journal Int J Infect Dis

Publisher Elsevier

Specialty Infectious Diseases

Date 2022 Apr 10

PMID 35398299

Authors

Xiaobing Wang

Jia Wei

Ruiping Zhu

Liping Chen

Feng Ding

Rui Zhou

Liuqing Ge

Jun Xiao

Qiu Zhao

Affiliations

Soon will be listed here.

Abstract

Objectives: This study aimed to explore the role of CD4+ T cells in the mechanisms of COVID-19 related diarrhea.

Methods: We analyzed lymphocyte subsets in patients with COVID-19 and the expression of angiotensin-converting enzyme 2 (ACE2), the transmembrane protease serine 2, and CD4+ T cell-related indicators in the colon were compared between patients with and without diarrhea. Correlation analyses were performed for ACE2 and other indicators to identify the relationship between SARS-CoV-2 infection and CD4+ mediated inflammation. The expression and distribution of CD4+ T cell-associated chemokines and their receptors were detected to determine the possibility of migration of CD4+ T cells to inflammation sites.

Results: The CD4+ T cell counts and percentages and CD4/CD8 ratio showed the most significant differences between the 2 groups. The diarrhea group expressed higher levels of ACE2, T-box expressed in T cells (Tbet), and tumor necrosis factor-alpha (TNFα) at both the mRNA and protein levels, with no difference from the nondiarrhea group for the percentage of ACE2+TNFα+ cells, indicating an indirect association between ACE2 and TNFα. The mRNA expression of CXCL10, CXCL11, and CXCR3 and the number of CD4+CXCR3+T cells were increased in the diarrhea group.

Conclusions: CD4+ T cell-mediated inflammation may contribute to COVID-19 related diarrhea. CXCR3+ mediated migration of CD4+ T cells into the gut may perpetuate inflammation.

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