Sani, Mastura Md
(2018)
CD4+ T cell subsets in adult allergic rhinitis patients attending Hospital Universiti Sains Malaysia.
Masters thesis, Universiti Sains Malaysia.
Abstract
Memory T cells exert effector function or generate effector cells in response
to antigen. The proportions of CD4+ T cell subsets especially memory cells in
allergic rhinitis (AR) patients sensitized to common allergens of house dust mites
(HDMs) and shellfish have not been extensively studied. This study aimed to
compare the mean percentages and absolute counts of CD4+ memory T cell subsets
between: (i) non-allergic controls and AR patients; (ii) mild AR patients and
moderate-severe AR patients. In addition, sensitization to common allergens,
symptom severity scores, and mean absolute counts of leukocyte subsets were also
determined. Fifty non-allergic controls and 100 AR patients diagnosed by physicians
were recruited in this study. However, only 33 non-allergic controls were included in
the analyses as others were excluded due to sensitization to the common allergens
(Dermatophagoides farinae (Der f), crab and shrimp) as measured by plasma
specific IgE tests. Stratified analyses were done based on two different definitions of
AR patients , i.e. (i) non IgE-mediated AR patients; and (ii) IgE-mediated AR
patients. Flow cytometry was used to determine the percentage of CD4+ naïve (TN;
CD45RA+ CCR7+), central memory (TCM; CD45RA- CCR7+), effector memory
(TEM; CD45RA- CCR7-) and terminally differentiated effector memory (TEMRA;
CD45RA+ CCR7-) T cells from the peripheral blood. The absolute counts of CD4+ T
cell subsets were obtained by dual platform methods from flow cytometer and
hematology analyzer. It was observed that AR patients sensitized to common
allergens (Dermatophagoides pteronyssinus, Der f, crab and shrimp) measured were
predominantly sensitized to HDMs as compared to shellfish allergens. Moderatesevere
AR patients had higher nasal and non-nasal symptom scores and reduced
quality of life as compared to mild AR patients. Furthermore, the eosinophil count
was significantly higher in IgE-mediated AR patients as compared to non-allergic
controls. There were no significant differences in the mean percentages and absolute
counts of CD4+ T cell subsets between non-allergic controls and IgE-mediated AR
patients. However, significant reduction in the mean percentage (p = 0.0287) and
absolute count (p = 0.0298) of CD4+ TEMRA cells were found in IgE-mediated
moderate-severe AR patients as compared to IgE-mediated mild AR patients and
14/25 (56.0%) IgE-mediated moderate-severe AR patients had persistent symptoms.
In conclusion, the mean percentage and absolute count of CD4+ CD45RA+ CCR7-
TEMRA cells were siginificantly reduced in IgE-mediated moderate-severe AR
patients as compared to IgE-mediated mild AR patients in our population of AR
patients predominantly sensitized to HDMs.
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