CD4 T cell loss and Th2 and Th17 bias are associated with the severity of severe fever with thrombocytopenia syndrome (SFTS)

Clin Immunol. 2018 Oct:195:8-17. doi: 10.1016/j.clim.2018.07.009. Epub 2018 Jul 20.

Abstract

Severe fever with thrombocytopenia syndrome (SFTS) is a newly emerging infectious disease caused by a novel bunyavirus with high mortality. Immune suppression is thought to be crucial in disease progression. However, data on immune responses during SFTS are scarce. This study aimed to evaluate the changes in CD4 T-cell subsets throughout the entirety of infection and analyse their relationships with disease severity in SFTS patients. In parallel with CD4 T-cell depletion, decreased Th1, Th2 and Treg numbers, but comparable Th17-cell numbers, were observed in deceased patients compared with those in surviving patients. Additionally, increased Th2 and Th17-cell percentages in the residual CD4 T-cell population led to aberrant Th2/Th1 and Th17/Treg ratios, which were positively correlated with disease severity. Collectively, our data indicated that CD4 T-cell deficiency, Th2 and Th17 bias were closely correlated with the severity of SFTS, indicating therapeutic potential of early immune interventions to ameliorate disease severity.

Keywords: Disease severity; Effector TH cell subsets; Regulatory T cells; Severe fever with thrombocytopenia syndrome; T lymphocytes.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Bunyaviridae Infections / immunology*
  • CD4 Antigens / metabolism
  • Disease Progression
  • Female
  • Humans
  • Immunosuppression Therapy
  • Lymphocyte Depletion
  • Male
  • Middle Aged
  • Phlebovirus / immunology*
  • Severity of Illness Index
  • T-Lymphocytes, Regulatory / immunology*
  • Th1 Cells / immunology*
  • Th1-Th2 Balance
  • Th17 Cells / immunology*
  • Th2 Cells / immunology*
  • Young Adult

Substances

  • CD4 Antigens