title: Increased regulatory T cells in patients with liver cirrhosis correlated with hyperbilirubinemia and predict bacterial complications.
abstract: OBJECTIVE
  Patients with liver cirrhosis (LC) were regarded as immunocompromised status with high incidence of bacterial infection. Regulatory T cell (Treg cell) is known as an immune suppressor and also plays an important role in patients with sepsis. This paper aims to study the role of Treg cells in patients with liver cirrhosis and their correlations to bacterial complications.
  
  
  METHODS
  Thirty-three normal controls (NC) and 82 cirrhotic patients were enrolled for the case-control study. The Treg cells, defined as CD4+ CD25+ Foxp3+ T cells, in peripheral blood of these patients were evaluated.
  
  
  RESULTS
  The percentage of Treg cells increased significantly in patients with liver cirrhosis when compared with normal volunteers. Furthermore, this increase of Treg cells was mainly memory phenotype defined as CD45RO+ Treg cells and was significantly correlated with serum bilirubin levels as evaluated by multiple linear regression analysis. In addition, the tumor necrosis factor (TNF)-α receptor II (TNFRII) expression also significantly increased on Treg cells in these patients. Interestingly, these membranous TNFRII would be shed and released into supernatant. Lastly, this increased percentage of Treg cells in cirrhotic patients correlate well with and predict subsequent bacterial complications.
  
  
  CONCLUSIONS
  The Treg cells, mainly with memory phenotype and with high TNFRII expression, increased significantly in patients with liver cirrhosis and significantly correlated with the serum bilirubin levels. Furthermore, this increased Treg cells correlate with and predict subsequent bacterial complications in cirrhotic patients.
authors.affiliation: Department of Gastroenterology and Hepatology, Chang-Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan; Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang-Gung University, Taoyuan, Taiwan.
authors.forename: Chien-Hao
authors.initials: CH
authors.lastname: Huang
authors.forename: Wen-Juei
authors.initials: WJ
authors.lastname: Jeng
authors.forename: Yu-Pin
authors.initials: YP
authors.lastname: Ho
authors.forename: Wei
authors.initials: W
authors.lastname: Teng
authors.forename: Wei-Ting
authors.initials: WT
authors.lastname: Chen
authors.forename: Yi-Cheng
authors.initials: YC
authors.lastname: Chen
authors.forename: Shi-Ming
authors.initials: SM
authors.lastname: Lin
authors.forename: Cheng-Tang
authors.initials: CT
authors.lastname: Chiu
authors.forename: I-Shyan
authors.initials: IS
authors.lastname: Sheen
authors.forename: Chun-Yen
authors.initials: CY
authors.lastname: Lin
mesh_terms: D000328:Adult; D000368:Aged; D001424:Bacterial Infections / Q000150:complications* / Q000175:diagnosis* / Q000276:immunology*; D001663:Bilirubin; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D005260:Female; D005544:Forecasting; D006801:Humans; D006932:Hyperbilirubinemia / Q000150:complications* / Q000276:immunology*; D016867:Immunocompromised Host / Q000276:immunology; D016014:Linear Models; D008103:Liver Cirrhosis / Q000150:complications* / Q000276:immunology*; D018655:Lymphocyte Count; D008297:Male; D008875:Middle Aged; D047889:Receptors, Tumor Necrosis Factor, Type II / Q000097:blood; D050378:T-Lymphocytes, Regulatory / Q000276:immunology*; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
chemical_list: D015415:Biomarkers; D047889:Receptors, Tumor Necrosis Factor, Type II; D014409:Tumor Necrosis Factor-alpha; D001663:Bilirubin
keywords: Child-Turcotte-Pugh classification; bacterial infections; liver cirrhosis; regulatory T cells; soluble tumor necrosis factor receptor II; tumor necrosis factor receptor II