Immunological balance of CD8+CD28+/CD8+CD28-T lymphocytes can predict gastrointestinal hemorrhage in patients with inflammatory bowel disease

doi:10.3969/j.issn.1673-4254.2016.12.04

Abstract：Objective To evaluate the sensitivity and specificity of CD8+CD28+/CD8+CD28T lymphocyte balance in predicting the gastrointestinal hemorrhage (GH) in patients with inflammatory bowel disease (IBD).Methods Forty-nine IBD patients,including 30 with ulcerous colitis (UC) and 19 with Crohn's disease (CD),were enrolled to test peripheral blood CD8+CD28+ and CD8 + CD28-T cells using flow cytometry.All the patients were followed up for one year.The receiver-operating characteristic (ROC) curves were used to test the efficiency of CD8+CD28+/CD8+CD28-T lymphocyte balance to predict GH.The differences in lasting time of remission (LTR) under different factors were compared using Kaplan-Meier survival analysis,and the correlation between CD8+ T lymphocytes and the factors were analyzed.Results The utilization rates of immunosuppressant,steroids,and biological agent (BA) were significantly higher in CD patients than in UC patients (P=0.003,0.043 and 0.002,respectively).The frequencies of CD8+CD28+T cells were obviously higher in UC patients than those in CD patients (t=3.022,P=0.004).CD8+CD28+T cells,CD8+CD28T cells,and especially CD8+CD28+/CD8+CD28-ratio (area under curve of 0.977,P=0.000;cut-off value of 1.14 [13.95％/12.24％] with a sensitivity of 93.3％ and a specificity of 91.2％) showed good efficiencies in predicting GH (P＜0.01).The mean and median of LTR of IBD patients who did not receive BA or surgical treatment were significantly longer (x2=9.730,P=0.002;x2=15.981,P=0.000).CD8+CD28+/CD8+CD28-ratio was significantly related to both BA (P=0.009) and surgery (P=0.038).Conclusion Both decreased CD8+ CD28 +T cells and elevated CD8 + CD28T cells are closely correlated with GH,and their ratio can predict the occurrence of GH with a high sensitivity and specificity and is correlated with BA and surgery at the cut-off value of 1.14.