ArticleIntensive care medicine2013
An increased alveolar CD4 + CD25 + Foxp3 + T-regulatory cell ratio in acute respiratory distress syndrome is associated with increased 30-day mortality.
Article in Intensive care medicine, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04482621 (Decitabine for COVID-19 Pneumonia-ARDS Treatment), which is not on this map. Cited by 52 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Decitabine for COVID-19 Pneumonia-ARDS Treatment: DART Trial
Who cites it
52 citing papers in PubMed, 2 syntheses or guidelines pooled it, 97 citations in OpenAlex.
- A systematic review of biomarkers multivariately associated with acute respiratory distress syndrome development and mortality.Critical care (London, England) · 2020Pooled it
- Lung fluid biomarkers for acute respiratory distress syndrome: a systematic review and meta-analysis.Critical care (London, England) · 2019Pooled it
- Pentoxifylline decreases serum LDH levels and increases lymphocyte count in COVID-19 patients: Results from an external pilot study.International immunopharmacology · 2021Trial
- Chlorogenic acid mitigates acute respiratory distress syndrome via inhibition of the PI3K/AKT signalling pathway: an integrated analysis of bioinformatics and validation experiments.Annals of medicine · 2025Article
- T Regulatory Mechanisms in Airway and Interstitial Lung Disease.Seminars in respiratory and critical care medicine · 2025Review
- The Complex Immune Cell Composition and Cellular Interaction in the Alveolar Compartment of Patients with Acute Respiratory Distress Syndrome.American journal of respiratory cell and molecular biology · 2025Review
- Dysregulated Immune Responses in Sepsis: Insights From Treg-Related Gene Expression.Journal of inflammation research · 2025Article
- From pancreas to lungs: The role of immune cells in severe acute pancreatitis and acute lung injury.Immunity, inflammation and disease · 2024Review
- Corticosteroids treatment for pediatric acute respiratory syndrome: A critical review.Saudi medical journal · 2023Review
- Dysfunctional phenotype of systemic and pulmonary regulatory T cells associate with lethal COVID-19 cases.Immunology · 2023Article
- Complement as a vital nexus of the pathobiological connectome for acute respiratory distress syndrome: An emerging therapeutic target.Frontiers in immunology · 2023Review
- Article
- Low BALF CD4 T cells count is associated with extubation failure and mortality in critically ill covid-19 pneumonia.Annals of medicine · 2022Article
- Total bilirubin is associated with all-cause mortality in patients with acute respiratory distress syndrome: a retrospective study.Annals of translational medicine · 2022Article
- Regulatory T cells in inflammation and resolution of acute lung injury.The clinical respiratory journal · 2022Review
- Bone marrow mesenchymal stem cells attenuate LPS-induced acute lung injury in mice by promoting RvE1/ProD1 and modulating Treg/Th17 balance.Turkish journal of biology = Turk biyoloji dergisi · 2022Article
- PARP-1 Inhibition Repressed Imbalance of Th17 and Treg Cells in Preterm Rats with Intrauterine Infection-Induced Acute Respiratory Distress Syndrome by Reducing the Expression Level of IL-6.Journal of healthcare engineering · 2022Article
- Upregulation of FOXP3 is associated with severity of hypoxia and poor outcomes in COVID-19 patients.Virology · 2021Article
- Potential therapeutics in pediatric acute respiratory distress syndrome: what does the immune system have to offer? A narrative review.Translational pediatrics · 2021Review
- Mortality Prediction Utilizing Blood Biomarkers to Predict the Severity of COVID-19 Using Machine Learning Technique.Diagnostics (Basel, Switzerland) · 2021Article
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Authors and funding
7 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeCell therapy may become an option for lung injury treatment. However, no data are available on the alveolar presence and time course of CD4+ CD25 + Foxp3 + T-regulatory lymphocyte cells (Tregs) in acute respiratory distress syndrome (ARDS). Accordingly, we (1) measured the ratio of CD4 + CD25 + Foxp3 + Tregs to all (CD4+) lymphocytes in the bronchoalveolar lavage (BAL) of ARDS patients and of control subjects without lung disease and (2) assessed their impact on 30-day mortality.
methodsIn a prospective study, the ratios of CD4 + CD25 + Foxp3 + T-regulatory cells to all CD4+ cells were measured (FACS) within 24 h of the patients' ICU referral in the BAL and in the blood of 47 patients with ARDS (32 males, 15 females; mean age 44 years ±13) as well as in 8 controls undergoing elective abdominal surgery (5 men, 3 women; mean age 49 years ±4). BAL concentrations of several cytokines were also measured in ARDS patients.
resultsTregs were detected in the BAL of control subjects and ARDS patients. However, the mean ratio of Tregs to all CD4+ lymphocytes was threefold greater in ARDS non-survivors (16.5%; p = 0.025) and almost twofold greater in ARDS survivors (9.0%; p = 0.015) compared to controls (5.9%). Multivariate Cox regression analysis revealed the ratio of CD4 + CD25 + Foxp3 + T-regulatory lymphocytes to all CD4+ lymphocytes in the BAL to be an important and independent prognostic factor for 30-day survival (HR 6.5; 95% CI, 1.7-25; p = 0.006).
conclusionAn increased T-regulatory cell ratio in the admission BAL of patients with ARDS is an important and independent risk factor for 30-day mortality.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.