Effect of lymphocyte immunotherapy on T lymphocyte subset distribution and PD1/PD-L1 expression in patients with recurrent miscarriage
Objective:To explore the effect of lymphocyte immunotherapy on the distribution of T lymphocyte subsets and the expression of programmed cell death 1 (PD1)/programmed cell death-ligand 1 (PD-L1) in patients with recurrent spontaneous abortion (RSA).Methods:A total of 120 RSA patients who received lymphocyte immunotherapy at the First Affiliated Hospital of Hainan Medical University from January 2019 to January 2021 were selected as a research group, and another 120 healthy women who underwent physical examination at the hospital during the same period were selected as a control group. The mean age of patients in the research group was (28.57±7.22) years, and it was (29.55±6.28) years in the control group. The distribution of peripheral lymphocyte T subsets (CD3+, CD4+, CD8+, and CD4+/CD8+ ratio) and PD1/PD-L1 expression levels in the two groups were determined by flow cytometry and compared before and after the treatment.Results:Before the treatment, the percentages of CD3+ and CD8+ T lymphocyte subsets in the research group were both lower than those in the control group (62.77%±6.95% vs 69.02%±7.17% and 34.16%±4.82% vs 39.67%±5.06%, respectively, P＜0.05 for both), and the percentage of CD4+ T lymphocyte subset and CD4+/CD8+ ratio were both higher in the research group (55.16%±7.11% vs 47.66%±6.69% and 1.62±0.53 vs 1.32±0.40, respectively, P＜0.05 for both). After the treatment, the PD1 expression levels in CD4+ and CD8+ T lymphocytes of the research group were significantly lower than those in the control group (P＜0.05 for both). Similarly, the PD-L1 expression levels in CD4+ and CD8+ T lymphocytes of the research group were also significantly lower than those in the control group (P＜0.05 for both). After the treatment, the percentage of CD3+ and CD8+ T lymphocyte subsets in the research group showed a significant increase compared to those before treatment, while the percentage of CD4+ T lymphocyte subset and CD4+/CD8+ ratio showed a significant decrease (P＜0.05 for all). After the treatment, both PD1 expression levels in CD4+ and CD8+ T lymphocytes and PD-L1 expression levels in CD4+ and CD8+ T lymphocytes of the research group were significantly higher compared to those before treatment (P＜0.05 for all).Conclusions:Compared to healthy females, patients with RSA have lower percentages of T lymphocyte subpopulations and lower expression levels of PD1/PD-L1, which may be involved in the progression of RSA. Adopting lymphocyte immunotherapy can increase the percentages of T lymphocyte subpopulations and the expression levels of PD1/PD-L1, thereby improving the immune status of the patients.
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