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Journal of Nippon Medical School

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Effects of Drug Therapy on T Lymphocyte Subsets and the Associations of These Subsets with Recurrent Chronic Bronchitis Attacks

Jing Zhang1, Shan Wang1, Yun Shi1 and Chunting Tan2

1Department of Geriatric Medicine, Medical Health Center, Beijing Friendship Hospital, Capital Medical University, Beijing, China
2Department of Respiratory Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing, China


Background: We evaluated the effects of drug therapy on T lymphocyte subsets and their associations with recurrent chronic bronchitis (CB) attacks.
Methods: A total of 162 CB patients treated from April 2020 to April 2021 were selected. All patients underwent anti-infective, cough-relieving, and phlegm-eliminating treatment, as detailed in Clinical Pathway for Chronic Bronchitis. They were divided into a recurrent attack group (n=95) and a non-recurrent attack group (n=67). Changes in T lymphocyte subsets at different time points of treatment and their associations with the number of attacks were analyzed. Associated factors were analyzed in a multivariate logistic regression model, and their predictive value was validated using a nomogram prediction model and receiver operating characteristic (ROC) curves.
Results: The number of attacks at 1 year after treatment was positively correlated with CD8+ and negatively correlated with CD3+, CD4+, and CD4+/CD8+. A history of smoking, CD3+, CD4+, CD8+, and CD4+/CD8+ were independent risk factors for recurrent attacks. The nomogram prediction model showed that the total risk value corresponding to smoking history, low CD3+, CD4+, and CD4+/CD8+, and elevated CD8+ was 0.86, and the concordance index and area under the ROC curve of the model was 0.896 (95% CI: 0.782-0.997, P<0.05) and 0.816 (95% CI: 0.803-0.847, P<0.001), respectively. There was an association between T lymphocyte subsets and recurrent attacks before and after treatment of CB.
Conclusions: Low CD3+, CD4+/CD8+ and CD4+, elevated CD8+, and smoking history were risk factors for recurrent attack.

J Nippon Med Sch 2025; 92: 61-68

Keywords
chronic bronchitis, T lymphocyte subset, recurrent attack

Correspondence to
Chunting Tan, Department of Respiratory Medicine, Beijing Friendship Hospital, Capital Medical University, 95 Yong'an Road, Xicheng District, Beijing 100050, China
chuntingtan@ccmu.edu.cn

Received, December 9, 2022
Accepted, October 30, 2024