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ORIGINAL RESEARCH article

Front. Immunol.
Sec. Comparative Immunology
Volume 15 - 2024 | doi: 10.3389/fimmu.2024.1506073
This article is part of the Research Topic The Novel Insight into Managements of Undiagnosed Pleural Effusion View all articles

Immunological characterization of pleural effusions in pediatric patients

Provisionally accepted
Regine Weber Regine Weber 1*Luca Flögel Luca Flögel 1Elisabeth Kaiser Elisabeth Kaiser 1Muriel Charlotte Hans Muriel Charlotte Hans 1Sybelle Goedicke-Fritz Sybelle Goedicke-Fritz 1Michelle Bous Michelle Bous 1Hashim Abdul-Khaliq Hashim Abdul-Khaliq 2Martin Poryo Martin Poryo 2Michael Zemlin Michael Zemlin 1
  • 1 Department of General Pediatrics and Neonatology, Saarland University, Campus Homburg, Homburg/Saar, Germany
  • 2 Department of Pediatric Cardiology, Saarland University Medical Center, Homburg/Saar, Germany

The final, formatted version of the article will be published soon.

    Background: The pleural cavity represents a unique immunological compartment that can mount inflammatory reactions during infections, after surgery and in chronic immunological diseases. The connection between systemic immune reactions in the blood and local immune reactions in pleural effusions remains unclear. This study provides the first comprehensive immunological characterization of paired blood and pleural effusion samples, utilizing combined cell and cytokine analyses in pediatric patients undergoing cardiac surgery.Methods: In 30 pediatric patients (median age: 22 months) with pleural effusion after cardiac surgery for congenital heart defects, corresponding peripheral blood and pleural effusion samples were analyzed for their immune response. We used flow cytometry and multiplex immunoassays to quantify 14 T cell subpopulations and 12 T cell associated cytokines in each biosample.Results: IL-6, IL-8, IL-10, TNF (p<0.0001) levels were significantly higher in pleural effusion compared to plasma. In contrast, IFN-γ, GM-CSF, IL-17A levels were lower in pleural effusion than in plasma (p≤0.0005). In comparison to peripheral blood, there was a significantly higher proportion of T helper cells 1 (Th1, p=0.0023), T helper cells 17 (Th17, p=0.0334) and memory effector cytotoxic T cells (CD3 + CD8 + CD45RO + CD62L -, p=0.0449) in pleural effusion and the same trend was observed for memory effector Th cells (CD3 + CD4 + CD45RO + CD62L -, p=0.0633) and double-negative T cells (CD3 + CD4 -CD8 -) (p=0.1085). Naïve Th cells (CD3 + CD4 + CD45RO -CD62L + ) and naïve cytotoxic T cells (CD3 + CD8 + CD45RO -CD62L + ) were slightly reduced in pleural effusion compared to peripheral blood (not significant).Conclusion: Immunological factors in pleural effusions differed significantly from the corresponding blood samples in pediatric patients after cardiac surgery. The results suggest localized production of specific cytokines within the pleural space, while the distribution of other cytokines in pleural effusions appears to be more reflective of the systemic immune response. We found evidence that on the cellular level, the surface marker CD62L may play a key role in navigating T cells between the blood and

    Keywords: Pleural Effusion, T cells immunology differentiation, neonates, cardiac surgery, Pediatrics

    Received: 04 Oct 2024; Accepted: 02 Dec 2024.

    Copyright: © 2024 Weber, Flögel, Kaiser, Hans, Goedicke-Fritz, Bous, Abdul-Khaliq, Poryo and Zemlin. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Regine Weber, Department of General Pediatrics and Neonatology, Saarland University, Campus Homburg, Homburg/Saar, Germany

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