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Journal of Peking University (Health Sciences) ›› 2026, Vol. 58 ›› Issue (3): 624-630. doi: 10.19723/j.issn.1671-167X.2026.03.024

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Expression and clinical significance of lymphocyte subsets in infectious pneumonia and immune-related interstitial lung disease

Doudou ZHAO1,2, Xuan QI1,3, Bo HUANG1, Weibo GAO4, Yuanyuan PEI4, Yuebo JIN1, Miao SHAO1, Jing HE1,*()   

  1. 1. Peking University People's Hospital, Rheumatology and Immunology Department, Beijing 100044, China
    2. Jincheng People's Hospital, Rheumatology and Immunology Department, Jincheng 048000, Shanxi, China
    3. The Second Hospital of Hebei Medical University, Rheumatology and Immunology Department, Shijiazhuang 050000, China
    4. Peking University People's Hospital, Emergency Department, Beijing 100044, China
  • Received:2024-07-26 Online:2026-06-18 Published:2026-04-09
  • Contact: Jing HE

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Abstract:

Objective: To delineate differences in lymphocyte subset expression between patients with infectious pneumonia and immune-related interstitial lung disease (IRILD), to assess the immune status across distinct pneumonia types, and to provide novel laboratory markers through immunological profiling to effectively differentiate pneumonias. Methods: A total of 78 patients sequentially enrolled from Peking University People' s Hospital between January 2023 and March 2024 were stratified into three groups: 27 with infectious pneumonia, 27 with isolated immune-related interstitial lung disease (IRILD), and 24 with IRILD complicated by infection. Fifty age-matched healthy individuals undergoing routine physical examinations during the same period served as controls. Peripheral lymphocyte subsets were quantified in all subjects by multiparametric flow cytometry. Results: There was no statistically significant difference in age between the pneumonia patients and the healthy control group in this study (P>0.05). Analysis of laboratory parameters revealed that compared with the IRILD group, the infectious pneumonia group demonstrated significantly elevated levels of neutrophils, C-reactive protein, procalcitonin (PCT), erythrocyte sedimentation rate (ESR), D-dimer, and fibrinogen (P < 0.05), while the IRILD with superimposed infection group exhibited significantly increased levels of PCT, ESR, and immunoglobulin G (P < 0.05). At the lymphocyte subset level, compared with the control group, the infectious pneumonia group exhibited significantly decreased counts of T cells, B cells, natural killer (NK) cells, CD4+T cells, and the CD4+/CD8+ ratio (P < 0.05). Similarly, compared with the control group, the IRILD group showed significantly reduced counts of T cells, B cells, CD4+T cells, and the CD4+/CD8+ ratio (P < 0.05). Furthermore, compared with the control group, the IRILD-with-infection group demonstrated significantly lower counts of T cells, B cells, NK cells, CD4+T cells, and CD8+T cells (P < 0.05). Compared with the IRILD group, the infectious pneumonia group had a significantly lower NK cell count (P < 0.05). Additionally, compared with the IRILD group, the IRILD-with-infection group displayed significantly reduced counts of NK cells and CD8+T cells (P < 0.05). Conclusion: The study revealed significant variations in lymphocyte subset profiles among the distinct pneumonia groups, providing novel insights with potential diagnostic value for differentiating between pneumonia types.

Key words: Infectious pneumonia, Immune-related interstitial lung disease, Lymphocyte subpopulations

CLC Number: 

  • R563

Table 1

Comparison of baseline data of patients"

Items Control (n=50) Infectious pneumonia (n=27) IRILD (n=27) IRILD with infection (n=24) F/χ2 P
Male 17 (34.0) 19 (70.4) 8 (29.6) 9 (37.5) χ2=11.82 P＜0.05
Age/years 55.3±9.4 60.3±16.9 60.5±13.9 60.0±12.8 F=1.50 P＞0.05
Infection type χ2=2.06 P＞0.05
  Virus 10 (37.0) 6 (25.0)
  Bacteria 14 (51.9) 17 (70.8)
  Bacteria + virus 2 (7.4)
  Fungus 1 (3.7) 1 (4.2)
IRILD etiology χ2=5.56 P＞0.05
  IIM 12 (44.4) 12 (50.0)
  RA 2 (7.4) 3 (12.5)
  SS 2 (7.4) 3 (12.5)
  SSc 2 (8.3)
  AAV 1 (4.2)
  IPAF 11 (40.8) 3 (12.5)

Table 2

Comparison of clinical characteristics among patient groups"

Characteristics Infectious pneumonia group(n=27) IRILD group(n=27) IRILD with infection group(n=24) F/x2/H P value
Common symptoms
  Fever 24 (88.9) 2 (7.4)a 13 (54.2)a，b χ2=36.09 P＜0.001
  Cough 18 (66.7) 8 (29.6)a，c 19 (79.2) χ2=14.14 P＜0.001
  Dyspnea 5 (18.5) 3 (11.1) 7 (29.2) χ2=2.59 0.321#
Co-existing complications
  Other 11 (40.7) 17 (63.0) 14 (58.3) χ2=2.96 0.222
  Hypertension 14 (51.9) 8 (29.6) 6 (25.0) χ2=4.69 0.101
  Diabetes 11 (40.7) 6 (22.2) 4 (16.7) χ2=4.96 0.20#
  CVD 2 (7.4) 2 (7.4) 4 (16.7) χ2=1.45 0.577#
Biochemical indexes
  WBC/(×109/L) 8.73 (5.61, 10.75) 7.80 (6.39, 8.30) 7.09 (5.15, 9.63) H=3.59 0.166
  LYM/(×109/L) 1.32±0.77 1.73±0.91 1.28±0.64 F=2.61 0.080
  NEU/(×109/L) 6.72 (4.42, 8.30)b 4.85 (3.80, 5.58) 5.17 (3.68, 7.27) H=6.57 0.038
  HB/(g/L) 110.40±21.78 129.89±16.90a 122.25±16.24a F=7.55 0.001
  PLT/(×109/L) 234.48±127.90 230.89±76.54 262.38±101.67 F=0.68 0.509
  ALT/(U/L) 22.00 (12.00, 36.00) 18.00 (13.00, 27.00) 15.00 (11.25, 49.75) H=0.38 0.828
  AST/(U/L) 21.00 (15.00, 28.00) 21.00 (16.00, 24.00) 26.00 (18.00, 37.75) H=2.13 0.346
  Scr/(μmol/L) 77.00 (60.00, 138.96) 65.00 (55.00, 79.00) 72.00 (56.25, 83.00) H=3.46 0.177
  CRP/(mg/L) 55.40 (14.20, 91.80) 1.10 (0.50, 3.90)a 5.90 (1.30, 24.70)a H=28.95 P＜0.001
  PCT/(μg/L) 0.15 (0.10, 0.61)b 0.04 (0.03, 0.07) 0.20 (0.06, 0.52)b H=21.42 P＜0.001
  ESR/(mm/h) 47.32 (39.00, 53.00)b 13.00 (7.00, 18.00) 33.50 (11.00, 70.00)b H=28.95 P＜0.001
  D-dimer/(μg/L) 477.00 (203.00, 1 146.00)b 112.00 (75.00, 322.80) 254.00 (92.75, 496.25) H=14.67 P＜0.001
  FIB/(mg/dL) 417.50±105.09 330.58±54.89a 377.33±115.00 F=5.72 0.005
  IgG/(g/L) 9.40±3.66c 11.49±3.66c 15.81±4.47 F=17.37 P＜0.001
  IgA/(g/L) 2.00 (1.48, 2.26) 2.37 (1.63, 2.79) 2.65 (1.94, 3.36) H=5.79 0.055
  IgM/(g/L) 0.91 (0.43, 1.07) 1.05 (0.67, 1.52) 1.14 (0.77, 2.07) H=5.34 0.069
  C3/(g/L) 1.29±0.29c 1.34±0.18c 1.14±0.29 F=3.73 0.028
  C4/(g/L) 0.38 (0.36, 0.41)c 0.34 (0.27, 0.41) 0.26 (1.94, 3.36) H=11.18 0.004
Initial treatment
  GC therapy 0 (0) 23 (85.2)a 21 (87.5)a χ2=61.00 P＜0.001#
  csDMARDs 0 (0) 23 (85.2)a 22 (91.7)a χ2=64.43 P＜0.001#
  tDMARDs 0 (0) 1 (3.7) 5 (20.8)a χ2=7.02 0.012#

Figure 1

Comparative expression levels of lymphocyte subsets A, T lymphocyte count comparison; B, B lymphocyte count comparison; C, NK count comparison; D, CD4+ cell count comparison; E, CD8+ cell count comparison; F, CD4/CD8 ratio comparison. Control, health control group; Pneumonia, infectious pneumonia group; IRILD, immune-related interstitial lung disease group; IRILD-infection, immune-related interstitial lung disease with concurrent infection group.* P < 0.05, * * P < 0.01, * * * P < 0.001, * * * * P < 0.000 1."

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