Decreased CD8+CD28+/CD8+CD28-- T cell ratio can sensitively predict poor outcome for patients with complicated Crohn disease

ECU Author/Contributor (non-ECU co-authors, if there are any, appear on document)

Shi-xue,Gu,Hong-xiang,Lin,Qian-yi,Wu,Yan-kun,Wang, Dai (Creator)

Institution

East Carolina University (ECU )

Web Site: http://www.ecu.edu/lib/

Abstract: Crohn disease (CD) with complications such as penetrating, stricturing, and perianal disease is called complicated CD. The aim of this study is to test the efficiency with which the CD8+CD28+/CD8+CD28-- cell balance can predict a subsequent active stage in patients with newly diagnosed complicated CD.Seventeen patients with complicated CD and 48 CD patients with no complications were enrolled. Blood CD8+ T cells were tested from all of the 65 newly diagnosed CD patients upon enrollment. The potential risk factors were compared between the 2 groups. A 30-week follow-up was performed, and the efficiency of the CD8+ cell balance at predicting active CD was analyzed using receiver- operating characteristic curves. The cumulative remission lasting rates (CRLRs) were analyzed using the Kaplan--Meier method.Compared with the control CD group, patients with complicated CD were predominantly male and younger in age; they also had lower body mass indices (BMIs), higher Crohn disease activity indices (CDAIs), higher immunosuppressant and steroid prescription rates, and significantly higher surgical rates. The CD8+CD28+/CD8+CD28-- balance was associated with BMI, CDAI, steroids, and surgery. The CD8+CD28+/CD8+CD28-- ratios were significantly lower at week 0 and on the 6th, 22nd, and 30th week during follow- up with a shorter lasting time of remission for the complicated CD patients. The CD8+CD28+/CD8+CD28-- ratio could accurately predict the active stage for the patients with complicated CD, and the highest sensitivity (89.2%) and specificity (85.3%) were found when the ratio was 1.03. Treatment with steroids and surgery, along with a significantly lower CD8+CD28+/CD8+CD28-- ratio and lower CRLRs, was closely related to a worse outcome for the patients with complicated CD.Patients requiring steroids and surgery experience more severe disease activity and thus a disequilibrated immunological balance, which could be the main reason for a decreased CD8+CD28+/CD8+CD28-- ratio. This ratio can sensitively predict the active stage for patients with complicated CD, and more care should be taken when this ratio is <1.03.

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Language: English

Date: 2017

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