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The CD4+/CD8+ Ratio in Pulmonary Tuberculosis: Systematic and Meta-Analysis Article.

Yin Y, Qin J, Dai Y, Zeng F, Pei H, Wang J - Iran. J. Public Health (2015)

Bottom Line: Eight studies presented a significant decrease of CD4+/CD8+ ratio in PTB cases compared to healthy subjects (SMD: -0.45; 95% CI -0.65--0.25; I(2) = 7%).Other four studies researched on the newly diagnosed patients presented a more seriously and significantly decrease (SMD: -2.17; 95% CI -2.61--1.74; I(2) = 37%).The present meta-analysis indicated that there was a synthetic evidence for the reduced CD4+/CD8+ ratio in peripheral blood of PTB patients, especially newly diagnosed cases.

View Article: PubMed Central - PubMed

Affiliation: The Fifth People's Hospital of Wuxi, Affiliated to Jiangnan University, Wuxi, Jiangsu, China ; The Hospital for Infectious Diseases of Wuxi, Affiliated to Jiangnan University, Wuxi, Jiangsu, China.

ABSTRACT

Background: The ratio of CD4+/CD8+ has been used as a clinically index to evaluate patients' immunity. Numerous researchers have studied CD4+/CD8+ ratio in pulmonary tuberculosis (PTB) patients. However, the change of CD4+/CD8+ ratio remains controversial. We present a meta-analysis of 15 case-control studies to identify the change of CD4+/CD8+ ratio in PTB patients.

Methods: We assessed heterogeneity of effect estimates within each group using I(2) test. Subgroup analysis was performed to explore the potential source of heterogeneity. To investigate further the potential publication bias, we visually examined the funnel plots. For robustness of results, we performed sensitivity analysis by removing studies. Data entry and analyses were carried out with RevMan 5.2 (The Nordic Cochrane Centre).

Results: Twelve peripheral blood studies were categorized into two subgroups. Eight studies presented a significant decrease of CD4+/CD8+ ratio in PTB cases compared to healthy subjects (SMD: -0.45; 95% CI -0.65--0.25; I(2) = 7%). Other four studies researched on the newly diagnosed patients presented a more seriously and significantly decrease (SMD: -2.17; 95% CI -2.61--1.74; I(2) = 37%). The pooled analysis of bronchoalveolar lavage fluid (BALF) studies showed a significant increase of CD4+/CD8+ ratio using Flow Cytometry (FCM) (SMD: 4.75; 95% CI 3.44-6.05; I(2) =0%).

Conclusion: The present meta-analysis indicated that there was a synthetic evidence for the reduced CD4+/CD8+ ratio in peripheral blood of PTB patients, especially newly diagnosed cases. However, the CD4+/CD8+ ratio in BALF was increased using method of FCM.

No MeSH data available.


Related in: MedlinePlus

Forest plot of 5 BALF studies on the CD4+/CD8+ ratio of PTB group and HC group
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Figure 3: Forest plot of 5 BALF studies on the CD4+/CD8+ ratio of PTB group and HC group

Mentions: The forest plot shows a significant lower of CD4+/CD8+ ratio in pulmonary tuberculosis compared to healthy controls in the normal Peripheral blood studies (SMD: −0.45; 95% CI −0.65– −0.25; I2 = 7%). There are 4 studies researched on the newly diagnosed and before treatment patients compared to healthy controls, which is different from other 8 studies, based on available data, CD4+/CD8+ ratio in these 4 studies decreased more seriously and significantly (SMD: −2.17; 95% CI −2.6 –−1.74; I2 = 37%). Figure 3 summarizes the adjusted effect estimates of 5 BALF studies, which are categorized into two subgroups by the method of quantifying lymphocyte subpopulation, FCM (Flow Cytometry) and FM (Fluorescence Microscope). The forest plot shows a significant increase of CD4+/CD8+ ratio in pulmonary tuberculosis in studies of FCM (SMD: 4.75; 95% CI 3.44–6.05; I2 =0%), we did not report the summary effect estimates of the FM studies due to substantial heterogeneity (I2: 93%).


The CD4+/CD8+ Ratio in Pulmonary Tuberculosis: Systematic and Meta-Analysis Article.

Yin Y, Qin J, Dai Y, Zeng F, Pei H, Wang J - Iran. J. Public Health (2015)

Forest plot of 5 BALF studies on the CD4+/CD8+ ratio of PTB group and HC group
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4401876&req=5

Figure 3: Forest plot of 5 BALF studies on the CD4+/CD8+ ratio of PTB group and HC group
Mentions: The forest plot shows a significant lower of CD4+/CD8+ ratio in pulmonary tuberculosis compared to healthy controls in the normal Peripheral blood studies (SMD: −0.45; 95% CI −0.65– −0.25; I2 = 7%). There are 4 studies researched on the newly diagnosed and before treatment patients compared to healthy controls, which is different from other 8 studies, based on available data, CD4+/CD8+ ratio in these 4 studies decreased more seriously and significantly (SMD: −2.17; 95% CI −2.6 –−1.74; I2 = 37%). Figure 3 summarizes the adjusted effect estimates of 5 BALF studies, which are categorized into two subgroups by the method of quantifying lymphocyte subpopulation, FCM (Flow Cytometry) and FM (Fluorescence Microscope). The forest plot shows a significant increase of CD4+/CD8+ ratio in pulmonary tuberculosis in studies of FCM (SMD: 4.75; 95% CI 3.44–6.05; I2 =0%), we did not report the summary effect estimates of the FM studies due to substantial heterogeneity (I2: 93%).

Bottom Line: Eight studies presented a significant decrease of CD4+/CD8+ ratio in PTB cases compared to healthy subjects (SMD: -0.45; 95% CI -0.65--0.25; I(2) = 7%).Other four studies researched on the newly diagnosed patients presented a more seriously and significantly decrease (SMD: -2.17; 95% CI -2.61--1.74; I(2) = 37%).The present meta-analysis indicated that there was a synthetic evidence for the reduced CD4+/CD8+ ratio in peripheral blood of PTB patients, especially newly diagnosed cases.

View Article: PubMed Central - PubMed

Affiliation: The Fifth People's Hospital of Wuxi, Affiliated to Jiangnan University, Wuxi, Jiangsu, China ; The Hospital for Infectious Diseases of Wuxi, Affiliated to Jiangnan University, Wuxi, Jiangsu, China.

ABSTRACT

Background: The ratio of CD4+/CD8+ has been used as a clinically index to evaluate patients' immunity. Numerous researchers have studied CD4+/CD8+ ratio in pulmonary tuberculosis (PTB) patients. However, the change of CD4+/CD8+ ratio remains controversial. We present a meta-analysis of 15 case-control studies to identify the change of CD4+/CD8+ ratio in PTB patients.

Methods: We assessed heterogeneity of effect estimates within each group using I(2) test. Subgroup analysis was performed to explore the potential source of heterogeneity. To investigate further the potential publication bias, we visually examined the funnel plots. For robustness of results, we performed sensitivity analysis by removing studies. Data entry and analyses were carried out with RevMan 5.2 (The Nordic Cochrane Centre).

Results: Twelve peripheral blood studies were categorized into two subgroups. Eight studies presented a significant decrease of CD4+/CD8+ ratio in PTB cases compared to healthy subjects (SMD: -0.45; 95% CI -0.65--0.25; I(2) = 7%). Other four studies researched on the newly diagnosed patients presented a more seriously and significantly decrease (SMD: -2.17; 95% CI -2.61--1.74; I(2) = 37%). The pooled analysis of bronchoalveolar lavage fluid (BALF) studies showed a significant increase of CD4+/CD8+ ratio using Flow Cytometry (FCM) (SMD: 4.75; 95% CI 3.44-6.05; I(2) =0%).

Conclusion: The present meta-analysis indicated that there was a synthetic evidence for the reduced CD4+/CD8+ ratio in peripheral blood of PTB patients, especially newly diagnosed cases. However, the CD4+/CD8+ ratio in BALF was increased using method of FCM.

No MeSH data available.


Related in: MedlinePlus