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.
Keywords: ACE2; CD4+ T cells; COVID-19; SARS-CoV-2; diarrhea.
【저자키워드】 COVID-19, SARS-CoV-2, ACE2, diarrhea, CD4+ T cells, 【초록키워드】 Inflammation, Necrosis, Tumor, T cells, CXCL10, SARS-COV-2 infection, Lymphocyte subsets, chemokines, protease, diarrhea, angiotensin-converting enzyme 2, chemokine, lymphocyte, T cell, Migration, tumor necrosis factor, Lymphocyte subset, cells, mRNA, Patient, CD4+ T cells, receptor, transmembrane protease serine 2, distribution, expression, mechanism, CD4+ T cell, association, Angiotensin-converting enzyme, angiotensin, Gut, tumor necrosis, Colon, Correlation analysis, tumor necrosis factor-alpha, Serine, significant difference, no difference, percentages, TNFα, CD4+, transmembrane, CXCR3, inflammation sites, protein levels, CD4/CD8, correlation analyses, CXCL11, mRNA expression, serine 2, Cell, T-box, analyzed, identify, performed, determine, contribute, expressed, groups, patients with COVID-19, percentage, 【제목키워드】 Inflammation, CD4+, patients with COVID-19,