title: [Immunological balance of CD8+CD28+/CD8+CD28-T lymphocytes can predict gastrointestinal hemorrhage in patients with inflammatory bowel disease].
abstract: OBJECTIVE
  To evaluate the sensitivity and specificity of CD8+CD28+/CD8+CD28-T 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+CD28-T 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 (Χ2=9.730, P=0.002; Χ2=15.981, P=0.000). CD8+CD28+/CD8+CD28-ratio was significantly related to both BA (P=0.009) and surgery (P=0.038).
  
  
  CONCLUSIONS
  Both decreased CD8+CD28+T cells and elevated CD8+CD28-T 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.
authors.affiliation: 1Department of Rheumatology, TCM-integrated Hospital of Southern Medical University, Guangzhou 510315, China; 2Department of Emergency Medicine, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China. E-mail: shixuedai@hotmail.com.
authors.forename: Shi-Xue
authors.initials: SX
authors.lastname: Dai
authors.forename: Hong-Xiang
authors.initials: HX
authors.lastname: Gu
authors.forename: Gang
authors.initials: G
authors.lastname: Wu
authors.forename: Tao
authors.initials: T
authors.lastname: Zhong
authors.forename: Hong-Jian
authors.initials: HJ
authors.lastname: Jian
authors.forename: Yong-le
authors.initials: YL
authors.lastname: Zhan
authors.forename: Min-Hai
authors.initials: MH
authors.lastname: Zhang
authors.forename: Yong
authors.initials: Y
authors.lastname: Gao
authors.forename: Jun
authors.initials: J
authors.lastname: Xu
authors.forename: Dong-Sheng
authors.initials: DS
authors.lastname: Chen
authors.forename: Guang-Jie
authors.initials: GJ
authors.lastname: Liao
authors.forename: Yan-Ling
authors.initials: YL
authors.lastname: Feng
authors.forename: Hong-Bo
authors.initials: HB
authors.lastname: Liu
authors.forename: Ying
authors.initials: Y
authors.lastname: Zou
authors.forename: Hong-Gang
authors.initials: HG
authors.lastname: Chi
mesh_terms: D018106:CD28 Antigens; D016827:CD8 Antigens; D018414:CD8-Positive T-Lymphocytes; D003093:Colitis, Ulcerative / Q000276:immunology; D003424:Crohn Disease / Q000276:immunology; D005434:Flow Cytometry; D006471:Gastrointestinal Hemorrhage / Q000276:immunology*; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000276:immunology*; D012372:ROC Curve; D012680:Sensitivity and Specificity
chemical_list: D018106:CD28 Antigens; D016827:CD8 Antigens