A Prospective Trial of Extracorporeal Photopheresis for Chronic Graft-versus-Host Disease Reveals Significant Disease Response and No Association with Frequency of Regulatory T Cells

Extracorporeal photopheresis (ECP) is an accepted treatment for chronic graft-versus-host disease (cGVHD); however, the mechanism of action is unclear. We conducted a prospective multicenter clinical trial to assess ECP response rates using the 2005 National Institutes of Health (NIH) consensus criteria and to assess the relationship between regulatory T cells (Tregs) and treatment response (NCT01324908). Eighty-three patients with any NIH subtype of cGVHD were enrolled, irrespective of number of prior lines of treatment, and 6 were subsequently excluded because of the absence of follow-up from cancer relapse, infection, or study withdrawal. Study outcomes were provider-assessed response and formal response by 2005 NIH criteria. Peripheral blood samples were collected at prespecified study visits and were analyzed by flow cytometry for Tregs. In a heavily pretreated cohort of patients, with a median of 2 prior lines of therapy, 62.3% of patients had a provider-assessed response to ECP and 43.5% had response by NIH criteria. These assessments showed only a slight agreement (kappa statistic, .09). In a logistic regression model that included previously identified risk factors such as bilirubin, platelet count, and time from transplant to study entry, no clinical factors were associated with the provider's response assessment. Furthermore, there was no significant difference in percentage of Tregs in blood leukocytes at study entry and completion or in overall change in Treg frequency between ECP responders and nonresponders. ECP was associated with a clinically significant decrease in median prednisone dose (.36 to .14 mg/kg, P < .001) from study entry to last visit and a significant decrease in global severity of cGVHD and total body surface area with erythematous rash. Overall, ECP was able to deliver response using NIH response criteria in a highly pretreated cohort with moderate and severe cGVHD independent of most previous risk factors for adverse outcomes of cGVHD.     

Treatment of Graft-versus-Host Disease with Naturally Occurring T Regulatory Cells

A significant body of evidence suggests that treatment with naturally occurring CD4⁺CD25⁺ T regulatory cells (Tregs) is an appropriate therapy for graft-versus-host disease (GvHD). GvHD is a major complication of bone marrow transplantation in which the transplanted immune system recognizes recipient tissues as a non-self and destroys them. In many cases, this condition significantly deteriorates the quality of life of the affected patients. It is also one of the most important causes of death after bone marrow transplantation. Tregs constitute a population responsible for dominant tolerance to self-tissues in the immune system. These cells prevent autoimmune and allergic reactions and decrease the risk of rejection of allotransplants. For these reasons, Tregs are considered as a cellular drug in GvHD. The results of the first clinical trials with these cells are already available. In this review we present important experimental facts which led to the clinical use of Tregs. We then critically evaluate specific requirements for Treg therapy in GvHD and therapies with Tregs currently under clinical investigation, including our experience and future perspectives on this kind of cellular treatment.     

Mammalian Target of Rapamycin Inhibitors Permit Regulatory T Cell Reconstitution and Inhibit Experimental Chronic Graft-versus-Host Disease

Chronic graft-versus-host disease (GVHD) remains a major late complication of allogeneic bone marrow transplantation (BMT). In a previous study, impaired thymic negative selection of the recipients permitted the emergence of pathogenic T cells that cause chronic GVHD using MHC class II-deficient (H2-Ab1 KO) B6 into C3H model and CD4⁺ T cells isolated from chronic GVHD mice caused chronic GVHD when administered into the secondary recipients. In this study, we evaluated the kinetics of regulatory T cell (Treg) reconstitution in wild type B6 into C3H model. After myeloablative conditioning, host Tregs disappeared rapidly, followed by expansion of Tregs derived from the donor splenic T cell inoculum. However, the donor splenic T cell–derived Treg pool contracted gradually and was almost completely replaced by newly generated donor bone marrow (BM)-derived Tregs in the late post-transplantation period. Next, we compared the effects of cyclosporine (CSA) and mammalian target of rapamycin (mTOR) inhibitors on Treg reconstitution. Administration of CSA significantly impaired Treg reconstitution in the spleen and thymus. In contrast, BM-derived Treg reconstitution was not impaired in mTOR inhibitor-treated mice. Histopathological examination indicated that mice treated with CSA, but not mTOR inhibitors, showed pathogenic features of chronic GVHD on day 120. Mice treated with CSA until day 60, but not mTOR inhibitors, developed severe chronic GVHD followed by adoptive transfer of the pathogenic CD4⁺ T cells isolated from H2-Ab1 KO into C3H model. These findings indicated that long-term use of CSA impairs reconstitution of BM-derived Tregs and increases the liability to chronic GVHD. The choice of immunosuppression, such as calcineurin inhibitor-free GVHD prophylaxis with mTOR inhibitor, may have important implications for the control of chronic GVHD after BMT.     

Subpopulations of Regulatory T Cells in Rheumatoid Arthritis, Systemic Lupus Erythematosus, and Behcet's Disease

Recently, subpopulations of regulatory T (Treg) cells, resting Treg (rTreg) and activated Treg (aTreg), have been discovered. The authors investigated the relationship between the change of Treg, aTreg and rTreg and autoimmune diseases. Treg cells and those subpopulations were analyzed by using the human regulatory T cell staining kit and CD45RA surface marker for 42 rheumatoid arthritis (RA), 13 systemic lupus sclerosis (SLE), 7 Behcet's disease (BD), and 22 healthy controls. The proportion of Treg cells was significantly lower in RA (3.8% ± 1.0%) (P < 0.001) and BD (3.3% ± 0.5%) (P < 0.01) compared to healthy controls (5.0% ± 1.3%). The proportion of aTreg cells was also significantly lower in RA (0.4% ± 0.2%) (P = 0.008) and BD (0.3% ± 0.1%) (P = 0.013) compared to healthy controls (0.6% ± 0.3%). The rTreg cells showed no significant differences. The ratio of aTreg to rTreg was lower in RA patients (0.4% ± 0.2%) than that in healthy controls (0.7% ± 0.4%) (P = 0.002). This study suggests that the decrement of aTreg not rTreg cells contributes the decrement of total Treg cells in peripheral blood of RA and BD autoimmune diseases. Detailed analysis of Treg subpopulations would be more informative than total Treg cells in investigating mechanism of autoimmune disease.     

可诱导 T 细胞共刺激分子在结肠癌组织中的表达情况及其与 远期生存的相关性研究

目的 探讨分析可诱导 T 细胞共刺激分子 (inducible T-cell co-stimulator, ICOS) 在结肠癌组织中 的表达情况及其与远期生存的相关性。 方法 选取 2018 年 5 月至 2019 年 5 月期间在大连大学附属新华医 院进行手术切除结肠组织的 206 例结肠癌患者作为研究对象, 取其结肠癌组织及癌旁组织标本, 使用荧光 定量 PCR 检测结肠癌组织及癌旁组织中可诱导 T 细胞共刺激分子表达水平, 分析其表达与临床病理特征的 关系及远期生存的相关性。 结果 结肠癌组织中 ICOS 表达水平 (8. 73 ± 2. 25) 显著低于癌旁组织的 (18. 54 ± 3. 26), 差异有统计学意义 (P< 0. 05); 结肠癌组织中 ICOS 表达水平与肿瘤直径、 远处转移、 临 床分期、 淋巴结转移有关 ( P < 0. 05), 与年龄、 性别、 肿瘤部位、 分化程度差异无统计学意义 ( P > 0. 05); ICOS 表达在 206 例结肠癌组织的中低表达 117 例, 高表达 89 例; ICOS 高表达和低表达与临床病理 因素进行 Logistic 二次回归分析结果显示, ICOS 表达与肿瘤大小、 临床分期、 淋巴结转移、 远处转移有关 (P< 0. 05), 与年龄、 性别、 肿瘤位置、 分化程度无关 (P > 0. 05); 随访截止至 2021 年 9 月 30 日, 206 例 结肠癌患者存活率 83. 01 % (171 / 206), 死亡率 16. 99 % (35 / 206), 中位生存时间为 (23. 5 ± 3. 3) 个 月。 ICOS 高表达的 89 例结肠癌患者的中位生存期为 (27. 4 ± 3. 2) 个月, 95 % CI 为 2. 234 ~ 6. 147; ICOS 低表达的 117 例结肠癌患者的中位生存期为 (16. 3 ± 4. 3) 个月, 95 % CI 为 1. 458 ~ 5. 237, ICOS 高表达结 肠癌患者中位生存期显著高于 ICOS 低表达者 (P< 0. 05)。 结论 ICOS 在结肠癌组织中呈较低表达, 其表 达水平与患者远期生存呈正相关关系, 其水平可作为结肠癌患者预后生存的重要评估指标。     

A Comparative Review of Methods for T Cell Depletion in the Prophylaxis of Graft-versus-Host Disease

Graft-versus-host disease (GVHD) remains the major problem to be overcome in transplantation of allogeneic haemopoietic stem cells. Using immunosuppressive prophylaxis with cyclosporin and methotrexate, moderate to severe acute GVHD develops in approximately 45% of transplant recipients with an HLA-identical sibling donor and in >75% of patients from unrelated HLA-identical or partially matched related donors. The pathophysiology of GVHD is complex and still incompletely described. Experimental and clinical data indicate that GVHD is largely mediated by immunocompetent T cells in the donor stem cell graft which are reactive against recipient (host) tissues. Depletion of these immunocompetent T cells from the stem cell graft offers a way to effectively prevent GVHD. The first section of this review describes the technical principles of different methods of T cell depletion. The advantages, limitations and level of T cell depletion achievable by physical methods or by positive and negative immunoselection procedures using monoclonal antibodies are comprehensively discussed. A short section concentrates on technical problems in the enumeration of T cells in the context of depletion efficiency. In the section on clinical studies, the focus is on the efficacy of different T cell depletion methods in avoiding GVHD in different clinical settings. The various methods are compared in transplantation from HLA-identical and nonidentical siblings or matched unrelated donors. The major drawbacks of T cell depletion are discussed in detail. Failure of engraftment and graft rejection is a more frequent problem following T cell-depleted transplants, particularly with HLA nonidentical donor-recipient pairs. An increase in leukaemic relapse rate is seen in certain haematological malignancies, especially in chronic myeloid leukaemia. Delayed recovery of anti-infectious immunity occurs, leading to an increased incidence of cytomegalovirus and Epstein-Barr virus related problems. The aim of this review is not only to give an overview of published studies but also to review strategies to circumvent the drawbacks of TCD. Consequently, we attempt to describe the potential role of cells removed by different depletion methods in graft protection, anti-infectious immunity and graft-versus-leukaemia reactivity. Finally, the possibility of recovering all components of the original graft and readministering them in controlled amounts and at controlled times is discussed. This strategy of 'balanced component therapy' may allow the combination of a low rate and severity of GVHD without the disadvantages of T cell depletion.     

Clonal Analysis of Regulatory T Cell Defect in Patients with Autoimmune Polyendocrine Syndrome Type 1 Suggests Intrathymic Impairment

Mutations in the autoimmune regulator gene disrupt thymic T cell development and negative selection, leading to the recessively inherited polyendocrine autoimmune disease autoimmune polyendocrine syndrome type 1 (APS‐1). The patients also have a functional defect in the FOXP3⁺ regulatory T cell population, but its origin is unclear. Here, we have used T cell receptor sequencing to analyse the clonal relationship of major CD4⁺ T cell subsets in three patients and three healthy controls. The naive regulatory T cells showed little overlap with helper T cell subsets, supporting divergence in the thymus. The activated/memory regulatory T cell subset displayed more sharing with helper T cells, but was mainly recruited from the naive regulatory T cell population. These clonal patterns were very similar in both patients and controls. However, naive regulatory T cells isolated from the patients had a significantly longer T cell receptor complementarity‐determining region 3 than any other population, suggesting failure of thymic selection. These data indicate that the peripheral differentiation of regulatory T cells in APS‐1 patients is not different from that in healthy controls. Rather, the patients' naive regulatory T cells may have an intrinsic defect imprinted already in the thymus.     

流式细胞术检测过敏性紫癜患儿外周血调节性T细胞的研究

目的了解过敏性紫癜（HSP）患儿外周血调节性T细胞数量的改变及其在过敏性紫癜患儿免疫功能紊乱中的调控作用。方法应用四色流式细胞术,对35例过敏性紫癜患儿和35例正常儿童的CD4^＋CD25^hi调节性T细胞、CD3^＋T淋巴细胞、CD3^＋CD4^＋辅助T细胞、CD3^＋CD8^＋抑制T细胞、CD19^＋B淋巴细胞、CD3^-CD16^＋ 56^＋NK细胞进行测定。结果HSP患儿外周血CD4^＋CD25^hi调节性T细胞、CD3^＋CD4^＋辅助T细胞、CD3-CD16^＋56＋NK细胞的百分率下降均明显低于对照组;CD19^＋B淋细胞的百分率则显著增高;而两组间CD3^＋T淋巴细胞、CD3^＋CD8^＋抑制T细胞的变化差异无统计学意义。结论HSP患儿体内存在细胞及体液免疫功能紊乱,CD4^＋CD25^＋调节性T细胞具有维持自身免疫耐受和调节免疫应答的功能,其数量下降可能是导致过敏性紫癜发病的重要原因之一。     

In Vivo T Cell Costimulation Blockade with Abatacept for Acute Graft-versus-Host Disease Prevention: A First-in-Disease Trial

We performed a first-in-disease trial of in vivo CD28:CD80/86 costimulation blockade with abatacept for acute graft-versus-host disease (aGVHD) prevention during unrelated-donor hematopoietic cell transplantation (HCT). All patients received cyclosporine/methotrexate plus 4 doses of abatacept (10 mg/kg/dose) on days −1, +5, +14, +28 post-HCT. The feasibility of adding abatacept, its pharmacokinetics, pharmacodynamics, and its impact on aGVHD, infection, relapse, and transplantation-related mortality (TRM) were assessed. All patients received the planned abatacept doses, and no infusion reactions were noted. Compared with a cohort of patients not receiving abatacept (the StdRx cohort), patients enrolled in the study (the ABA cohort) demonstrated significant inhibition of early CD4⁺ T cell proliferation and activation, affecting predominantly the effector memory (Tem) subpopulation, with 7- and 10-fold fewer proliferating and activated CD4⁺ Tem cells, respectively, at day+28 in the ABA cohort compared with the StdRx cohort (P < .01). The ABA patients demonstrated a low rate of aGVHD, despite robust immune reconstitution, with 2 of 10 patients diagnosed with grade II-IV aGVHD before day +100, no deaths from infection, no day +100 TRM, and with 7 of 10 evaluable patients surviving (median follow-up, 16 months). These results suggest that costimulation blockade with abatacept can significantly affect CD4⁺ T cell proliferation and activation post-transplantation, and may be an important adjunct to standard immunoprophylaxis for aGVHD in patients undergoing unrelated-donor HCT.     

T Cells from the Peripheral Blood of Coeliac Disease Patients Recognize Gluten Antigens when Presented by HLA-DR, -DQ, or -DP Molecules

Coeliac disease (CD) is a T-cell mediated immunological disease of the small intestine which is precipitated in susceptible individuals by ingestion of gluten. We recently reported that gliadin-specific T cells can be found in the small intestinal mucosa of CD patients, and that a preponderance of these T cells was restricted by the CD-associated DQ(%aL*0501, βl*0201)heterodimer. Here we report studies on whether the same is found for gliadin specific T cells in the peripheral blood of CD patients. T-cell responses towards gluten antigens in vitro were found for both most CD patients and healthy controls. Gluten-specific T-cell clones (TCC) were established from four CD patients. Although a large proportion of these TCC were restricted by DQ molecules, including the CD-associated DQ(α1*0501, β1*0201) heterodimer, several were restricted instead by DR or DP molecules. Thus, gluten-derived peptides can be presented to T cells by several different HLA elass-II molecules, and the preferential DQ(#aL1*0501, β1*0201) restriction of gluten-specific T cells in the small intestinal mucosa of CD patients is less pronounced than for similar T eells in the peripheral blood.     

溃疡性结肠炎患者外周血CD4+CD25+Treg细胞的表达及其意义

探讨CD4 CD25 Treg细胞在溃疡性结肠炎(UC)发病中的作用及其与疾病活动性的关系。采用三色流式细胞术检测52例UC患者,30例其它肠病患者和30名对照者。UC患者中活动期的30例,稳定期的22例,使用和未使用激素和/或免疫抑制剂活动期UC患者分别为18例和12例。对以上各组外周血中CD4 CD25 Treg细胞亚群的百分率进行测定。结果显示,活动期UC患者外周血CD4 CD25 Treg细胞比例明显低于其他肠病和对照组(P<0.001);疾病活动期UC患者外周血CD4 CD25 Treg细胞比例明显低于疾病稳定期患者(P<0.001);活动期UC患者中使用激素和/或免疫抑制剂与未使用激素和/或免疫抑制剂结果差异有统计学意义;UC患者外周血CD4 CD25 Treg细胞表达率与疾病活动指数评分呈负相关性,提示UC患者外周血CD4 CD25 Treg细胞异常表达,可能参与疾病的发生发展,与疾病的活动性密切相关。     

肺癌患者CD4+ CD25+调节性T细胞的检测及临床意义

目的:检测肺癌患者外周血CD4 CD25 调节性T细胞的分布并探讨相关机制.方法:采用流式细胞仪分析66例肺癌患者外周血CD4 CD25 调节性T细胞占CD4 T淋巴细胞的比例.结果:66例肺癌患者外周血中CD4 CD25 调节性T细胞占CD4 T淋巴细胞的比例为(16.2±2.4)%,与对照组(6.19±1.5)%比较差异有显著性(P＜0.05). 25例鳞癌、29例腺癌、12例小细胞癌患者外周血中CD4 CD25 调节性T细胞比例分别为(18.3±2.9)%、(15.6±1.8)%、(17.3±2.2)%,各组间比较差异无显著性(P＞0.05);均显著高于对照组(6.19±1.5)%,P＜0.05;34例Ⅲ期,14例Ⅳ期肺癌患者外周血中CD4 CD25 调节性T细胞比例为(15.3±2.6)%,(20.4±3.1%),均显著高于18例Ⅱ期患者(9.4±1.3)%,P均＜0.05.结论:肺癌患者外周血中有CD4 CD25 调节性T细胞比例增高,且与分期有关.它可能与肺癌患者免疫功能受损有关,可作为评估肺癌患者预后的一项指标.     

A Multiperspective Investigation of Social Competence in Children with Sickle Cell Disease

Compared the social competence and self-perceptions of 4- to8-year-old children with sickle cell disease (SCD) to a comparisongroup of healthy children. Social competence ratings were obtainedfrom multiple perspectives, including parents, teachers, andclinic staff members; children provided ratings of self-perceivedacceptance and competence. Children in the SCD group were ratedas socially competent as their peers in the comparison groupand the normative group. Differences across raters were found,however, with parents in the SCD group giving higher ratingsthan clinic staff members. No differences were revealed betweenchildren in the SCD group and the comparison group in theirself-perceptions of competence and acceptance. Implicationsfor future studies addressing the situational specificity ofsocial competence and its relevance to health care of chronicallyill children are discussed.     

Effects of Ca-Ionophore A23187 and Calmodulin Antagonists on Regulatory Mechanisms of Glycolysis and Cell Viability of NIH-3T3 Fibroblasts

We studied here, in NIH-3T3 fibroblasts, the effect of the Ca²⁺-ionophore A23187 (which is known to increase intracellular-free Ca²⁺) on the control of glycolysis and cell viability and the action of calmodulin antagonists. Time-response studies with Ca²⁺-ionophore A23187 have revealed dual effects on the distribution of phosphofructokinase (PFK) (EC 2.7.1.11), the rate-limiting enzyme of glycolysis, between the cytoskeletal and cytosolic (soluble) fractions of the cell. A short incubation (maximal effect after 7 min) caused an increase in cytoskeleton-bound PFK with a corresponding decrease in soluble activity. This leads to an enhancement of cytoskeletal glycolysis. A longer incubation with Ca²⁺-ionophore caused a reduction in both cytoskeletal and cytosolic PFK and cell death. Both the “physiological” and “pathological” phases of the Ca²⁺-induced changes in the distribution of PFK were prevented by treatment with three structurally different calmodulin antagonists, thioridazine, an antipsychotic phenothiazine, clotrimazole, from the group of antifungal azole derivatives that were recently recognized as calmodulin antagonists, and CGS 9343B, a more selective inhibitor of calmodulin activity. The longer incubation with Ca²⁺-ionophore also induced a decrease in the levels of glucose 1,6-bisphosphate and fructose 1,6-bisphosphate, the two allosteric stimulatory signal molecules of glycolysis. All these pathological changes preceded the reduction in cell viability, and a strong correlation was found between the fall in ATP and cell death. All three calmodulin antagonists prevented the pathological reduction in the levels of the allosteric effectors, ATP and cell viability. These experiments may throw light on the mechanisms underlying the therapeutic action of calmodulin antagonists that we previously found in treatment of the proliferating melanoma cells, on the one hand, and skin injuries, on the other hand.     

肿瘤病人外周血T细胞及其亚群和NK细胞活性变化的研究

一般认为,T细胞和NK细胞可能是构成机体肿瘤免疫功能的重要因素。肿瘤病人外周血T细胞及其亚群和NK细胞活性的变化,国内外均有报道。但对同一肿瘤病人T细胞及其亚群和NK细胞活性变化的对比研究报道得较少。本文用OKT系列的单克隆抗体检测T细胞及其亚群,用~(51)Cr-释放试验检测NK细胞活性,对同一肿瘤病人外     

Cardiovascular Responsivity, Type A Behavior, and Parental History of Heart Disease in Young Women

The purpose of this study was to examine the physiological responsiveness of Type A and Type B women during interpersonal and individual, competitive stressors. Extreme groups of Types A and B college-age women were monitored on heart rate and blood pressure while they engaged in an oral history quiz and the Stroop color/word test. Subjects were also subdivided by presence or absence of family history of coronary heart disease. Types A and B women did not differ on blood pressure levels or reactivity; Type A women did show a trend toward a greater increase in heart rate to the color/word task. Women with a positive family history had higher levels of systolic and a trend toward higher levels of diastolic blood pressure. There were no significant interactions of Type A/B with family history. Our conclusion is that Type A behavior is only very weakly, if at all, associated with physiological responsivity in young adult women.     

Prevention of Graft-versus-Host Disease by Adoptive T Regulatory Therapy Is Associated with Active Repression of Peripheral Blood Toll-Like Receptor 5 mRNA Expression

Acute graft-versus-host disease (GVHD) occurs in 40% to 60% of recipients of partially matched umbilical cord blood transplantation (UCBT). In a phase I study, adoptive transfer of expanded CD4⁺CD25⁺Foxp3⁺ natural regulatory T cells (nTregs) resulted in a reduced incidence of grade II-IV acute GVHD. To investigate potential mechanisms responsible for the reduced GVHD risk, we analyzed peripheral blood mononuclear cell mRNA expression of a tolerance gene set previously identified in operation- tolerant kidney transplant recipients, comparing healthy controls and patients who received nTregs and those who did not receive nTregs with and without experiencing GVHD. Samples from patients receiving nTregs regardless of GVHD status showed increased expression of Foxp3 expression, as well as B cell–related tolerance marker. This was correlated with early B cell recovery, predominately of naïve B cells, and nearly normal T cell reconstitution. CD8⁺ T cells showed reduced signs of activation (HLA-DR⁺ expression) compared with conventionally treated patients developing GVHD. In contrast, patients with GVHD had significantly increased TLR5 mRNA expression, whereas nTreg-treated patients without GVHD had reduced TLR5 mRNA expression. We identified Lin^-HLADR^-CD33⁺CD16⁺ cells and CD14⁺⁺CD16⁻ monocytes as the main TLR5 producers, especially in samples of conventionally treated patients developing GVHD. Taken together, these data reveal interesting similarities and differences between tolerant organ and nTreg-treated hematopoietic stem cell transplantation recipients.     

新生儿缺氧缺血性脑病患儿外周血CD4+CD25+调节性T细胞的变化及其意义

目的探讨CD4+CD25+调节性T细胞在新生儿缺氧缺血性脑病(HIE)患儿外周血的改变,及其在HIE疾病进程中的意义。方法用流式细胞术分析HIE组患儿92例和对照组31名外周血CD4+CD25+T细胞的变化,及其细胞内foxp3的表达变化。结果轻度、中度和重度HIE组患儿外周血CD4+CD25+T细胞比例分别为(9.26±1.18)%、(6.51±1.35)%和(5.36±1.54)%,对照组为(8.42±2.02)%。轻度HIE组患儿外周血CD4+CD25+T细胞较对照组有增高趋势,但差异无统计学意义(P>0.05);中度和重度HIE组患儿CD4+CD25+T细胞明显低于对照组,差异有统计学意义(P<0.05)。轻度、中度和重度HIE组患儿外周血CD4+CD25+foxp3+T细胞分别为(1.36±1.14)%、(1.21±0.94)%和(1.09±0.54)%,对照组为(1.30±1.17)%。轻度HIE组患儿CD4+CD25+foxp3+T细胞较对照组有增高趋势,但差异无统计学意义(P>0.05)。中度和重度HIE组患儿CD4+CD25+foxp3+T细胞明显低于对照组,差异有统计学意义(P<0.05)。结论中度和重度HIE组患儿CD4+CD25+foxp3+T细胞明显减少,这些调节性T细胞可能参与HIE的病理进程。