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Original Research: COPD |

CD4-Regulatory Cells in COPD Patients*

Lucy J. C. Smyth, PhD; Cerys Starkey, BSc; Jorgen Vestbo, MD; Dave Singh, MD
Author and Funding Information

*From North West Lung Centre, University of Manchester, South Manchester University Hospitals Trust, Manchester, UK.

Correspondence to: Lucy J. C. Smyth, PhD, NWLC, Wythenshawe Hospital, Southmoor Rd, Manchester M23 9LT, UK; e-mail: ljcsmyth@yahoo.co.uk



Chest. 2007;132(1):156-163. doi:10.1378/chest.07-0083
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Background: The numbers of airway CD8 and B lymphocytes are increased in COPD patients, suggesting an autoimmune process. CD4-regulatory T cells control autoimmunity but have not been studied in patients with COPD.

Objective: To compare T-regulatory cell numbers in the BAL from COPD patients, smokers with normal lung function, and healthy nonsmokers (HNS).

Methods: BAL and peripheral blood mononuclear cell (PBMC) samples were obtained from 26 COPD patients, 19 smokers, and 8 HNS. Flow cytometry was performed for regulatory phenotypic markers.

Results: COPD patients had increased BAL CD8 numbers compared to smokers and HNS. CD4 numbers were similar between groups. There was increased BAL CD4CD25(bright) expression in smokers (median 28.8%) and COPD patients (median 23.1%) compared to HNS (median 0%). Increased FoxP3 expression was confirmed in BAL CD4CD25(bright) cells. BAL CD4CD25 cells expressed less CD27 compared to PBMCs, suggesting weaker functional regulatory ability.

Clinical implications: Chronic cigarette smoke exposure up-regulates airway CD4 regulatory cell numbers. Their function may be to control pulmonary inflammation.

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