• Department of Respiratory Medicine, Yuhang District Second People′s Hospital of Hangzhou City. Hangzhou, Zhejiang,311121, China Corresponding Author: ZHAO Zhen-zhong, E-mail: zjz2008001@ sina. com;
Chronic obstructive pulmonary disease; Regulatory T cells; Insulin resistance; Flow cytometry
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Objective To investigate the changes of CD4 + CD25 + Foxp3 + regulatory T cells( Treg) in peripheral blood of patients with acute exacerbation of COPD( AECOPD) , and analyze the relationship of CD4 + CD25 + Foxp3 + Treg with insulin resistance.
Methods A total of 79 patients with AECOPD were divided into four groups according to disease severity( 11 cases in stage Ⅰ,31 cases in stage Ⅱ,28 cases in stage Ⅲ, an 9 cases in stage Ⅳ) .42 healthy volunteers were recruited as control. Fast blood glucose( FBG) and fast insulin( FINS) were measured for calculating the insulin resistance index. The CD4 + CD25 + Foxp3 + Treg were detected by flow cytometry. The relationship between the proportion and number of CD4 + CD25 + Foxp3 + Treg with insulin resistance was statistically analyzed.
Results Compared with the healthy control group, the levels of FBG, FINS, and insulin resistance index in the AECOPD patients were significantly higher ( P  lt; 0. 01, P  lt; 0. 05) . The proportion and number of CD4 + CD25 + Foxp3 + Treg in peripheral blood decreased significantly( P  lt; 0. 01, P  lt; 0. 05) . The insulin resistance index increased with the severity of AECOPD while the proportion and number of CD4 + CD25 + Foxp3 + Treg in peripheral blood decreased. The insulin resistance index in the AECOPD patients of stage Ⅲ and Ⅳ were higher than those of stage Ⅰ and Ⅱ. The proportion and number of CD4 + CD25 + Foxp3 + Treg in the AECOPD patients of stage Ⅲ and Ⅳ were significantly lower than those of stage Ⅰ and Ⅱ. Both the proportion and number of CD4 + CD25 + Foxp3 + Treg were negatively correlated with insulin resistance ( r = - 0. 633, - 0. 871, P  lt; 0. 01) .
Conclusions CD4 + CD25 + Foxp3 + Treg cells might may play important role in modulating insulin resistance in AECOPD. The more serious the disease, the lower the CD4 + CD25 + Foxp3 + Treg and the worse insulin resistance.

Citation： QIAN Yilong,ZHAO Zhenzhong,XIE Zhonghua,WANG Zhumei.. The Changes of CD4+ CD25+ Foxp3+ Regulatory T cells in Peripheral Blood of Patients with Acute Exacerbations of COPD and Its Relationship with Insulin Resistance. Chinese Journal of Respiratory and Critical Care Medicine, 2012, 11(6): 554-557. doi: Copy