Increased cytotoxic T-cells in the airways of adults with former bronchopulmonary dysplasia

• Bronchopulmonary dysplasia (BPD) in preterm-born infants is a risk factor for chronic airway obstruction in adulthood. Cytotoxic T-cells are implicated in COPD, but their involvement in BPD is not known.ObjectivesTo characterise the distribution of airway T-cell subsets in adults with a history of BPD.MethodsYoung adults with former BPD (n=22; median age 19.6 years), age-matched adults born preterm (n=22), patients with allergic asthma born at term (n=22) and healthy control subjects born at term (n=24) underwent bronchoalveolar lavage (BAL). T-cell subsets in BAL were analysed using flow cytometry.ResultsThe total number of cells and the differential cell counts in BAL were similar among the study groups. The percentage of CD3+CD8+T-cells was higher (p=0.005) and the proportion of CD3+CD4+T-cells was reduced (p=0.01) in the BPD group, resulting in a lower CD4/CD8 ratio (p=0.007) compared to the healthy controls (median 2.2versus5.3). In BPD and preterm-born study subjects, both CD3+CD4+T-cells (rs=0.38, p=0.03) and CD4/CD8 ratio (rs=0.44, p=0.01) correlated positively with forced expiratory volume in 1 s (FEV1). Furthermore, CD3+CD8+T-cells were negatively correlated with both FEV1and FEV1/forced vital capacity (rs= −0.44, p=0.09 and rs= −0.41, p=0.01, respectively).ConclusionsYoung adults with former BPD have a T-cell subset pattern in the airways resembling features of COPD. Our findings are compatible with the hypothesis that CD3+CD8+T-cells are involved in mechanisms behind chronic airway obstruction in these patients.

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