Öner ÖZDEMİR, Gülay TRAK, Mehmet Fatih ORHAN

COVİD-19 TANISI ALAN ÇOCUKLARIN B LENFOSİT HÜCRELERİNİN VE ALT GRUPLARININ AKIŞ SİTOMETRİK DEĞERLENDİRİLMESİ

Amaç: Viral enfeksiyonlar sırasında B hücrelerinin antikor üretimi, koruyucu bağışıklık için kritiktir. Çocuklarda COVID-19 hastalığının daha hafif seyrettiği bilinmektedir. Bu durumun nedenlerini çocuk doktoru gözüyle değerlendirmek, hastalığın tedavi hedeflerini belirlemek açısından çok önemlidir. COVID-19 enfeksiyonu tanısı alan çocuklarda gözlenen B hücre ve alt tiplerinde akım sitometrik değişiklikleri incelemeyi amaçladık.Gereç ve Yöntem: Çalışmamız 0-18 yaş arası COVID-19 teşhisi konulan 22 çocuğu içeren prospektif kohort bir araştırmadır. CD19+B hücreleri, CD27-IgD+ saf B, CD21düşük olgunlaşmamış B, CD21düşükCD38düşük aktif B, CD27-IgD- çift negatif B, CD27- bel- lek B, CD27+ bellek B, CD27+IgD- dönüşmüş (switched) bellek B, CD27+IgD+ dönüşmemiş (non-switched) bellek B hücreleri akış sitometrisi ile incelenmiştir.Bulgular: B hücre sayısı 2-5 yaş grubunda yüzde olarak, 10-16 yaş grubunda ise mutlak sayı olarak azaldı. 5-10 yaş ve 16 yaş üstü gruplarda naif ve hafıza dışı B hücrelerinin oranları arttı. Çift negatif B hücreleri tüm yaş gruplarında normaldi. Bellek dışı B hücreleri 5-10 yaş arasında ve 16 yaş üzerinde artarken, aynı gruplarda bellek B hücreleri azaldı. Dönüşmüş bellek B hücreleri tüm yaş gruplarında azaldı. Dönüşmemiş bellek B hücreleri, 16 yaşın üzerinde azaldı ve diğer tüm yaş gruplarında normal görünüyordu.Sonuç: B hücre sayısındaki azalma hastalığın şiddeti ile ilişkili olmasına rağmen, çalışmaya dâhil edilen çocuk hastalarımızda naif B hücre alt gruplarında azalma olmadı. Literatüre uygun olarak tüm gruplarda dönüşmüş bellek B hücreleri arttı. Çocuklarda yetişkinlerden farklı olarak naif B hücreleri, dönüşmemiş bellek B hücreleri ve çift negatif B hücreleri normaldi.

Anahtar Kelimeler:

Çocuk, İmmünoloji, COVID-19, Akış sitometrisi, B-lenfosit alt grupları

A FLOW CYTOMETRIC EVALUATION OF B LYMPHOCYTE CELLS AND SUBGROUPS OF CHILDREN DIAGNOSED WITH COVID-19

Objective: During viral infections, antibody production of B cells are critical for protective immunity. It is known that the COVID-19 disease has a milder course in children. It is crucial to evaluate the causes of this situation from a pediatrician’s perspective to determine the treatment goals of the disease. We aimed to examine the flow cytometric changes in B cells and subtypes observed in children diagnosed with the COVID-19 infection.Materials and Methods: This is a prospective cohort study including 22 children aged 0-18 who had been diagnosed with COVID-19. CD19+B cells, CD27-IgD+ naive B, CD21low immature B, CD21lowCD38low active B, CD27-IgD- double-negative B, CD27- non-memory B, CD27+ memory B, CD27+IgD- switched memory B, and CD27+IgD+ non-switched memory B cells were studied using flow cytometry.Results: B cells counts decreased as a percentage in the 2-5 years age group and the 10-16 age group as an absolute number. Naive and non-memory B cell frequencies increased in the 5-10 years old and over 16 years old groups. Double negative B cells were normal in all age groups. Non-memory B cells increased in the 5-10 and over 16 years old groups, whereas memory B cells decreased. In all groups, switched memory B cells decreased. Non-switched memory B cell counts were within reference ranges in all groups except for the over 16 years group.Conclusion: Although the decrease in B cell count is associated with the severity of the disease, naive B cell subgroups did not decrease in the pediatric patients included in the study. All groups showed increased switched memory B cell counts, in accordance with the literature. Unlike adults, naive B cells, non-switched memory B cells, and double-negative B cells were normal in children.

Keywords:

COVID-19, child, immunology, flow cytometry, B-lymphocyte subgroups,

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