Over-expression of CD8+ T-cell activation is associated with decreased CD4+ cells in patients seeking treatment of Alcohol Use Disorder

- Patients with alcohol use disorder (AUD) have more CD8+ immune activation than healthy individuals.
- The excess of activated CD8+ T cells correlates inversely with the CD4+ T cells.
- An activation indicator would be useful in clinical practice to identify risk of immunosuppression.

IntroductionHarmful alcohol consumption may have an impact on the adaptive immune system through an imbalance in T cell subpopulations and changes in cell activation. We aimed to analyze profiles of CD4 and CD8 T cell activation in patients with alcohol use disorder (AUD).MethodsWe used a cross-sectional study with patients seeking treatment of the disorder. Blood samples for immunophenotyping were obtained at admission. Profiles of T cell activation were defined: (I) CD38+/HLA-DR+, (II) CD38+/HLA-DR−, (III) CD38−/HLA-DR+, (IV) CD38−/HLA-DR− and compared with healthy controls. We calculated a CD8+ T cell activation indicator (AI) that was defined as the quotient of non-activated cells (CD38−/HLA-DR−) and activated cells (CD38+/HLA-DR+).Results60 patients were eligible (83% M); median age was 49 years [IQR: 44-54] and alcohol consumption was 145 g/day [IQR: 90-205]. Mean ± SD of CD38+/HLA-DR− was 50.3 ± 50.6 cells/μL in patients and 33.5 ± 24.5 cells/μL in controls (p = 0.03), for the CD38−/HLA-DR+ it was 61 ± 62.2 cells/μL in patients and 21.2 ± 17.3 cells/μL in controls (p < 0.001) and for the CD38+/HLA-DR+ it was 20.2 ± 15.6 cells/μL in patients and 10.8 ± 10.3 cells/μL in controls (p < 0.001). In patients, an inverse correlation was observed between absolute number and percentage of CD4+ T cells, and the percentage of CD38+/HLA-DR+CD8+ T cells (r = 0.37, p = 0.003; r = 0.2, p = 0.086, respectively).ConclusionsPatients with AUD have an increased expression of immune activation with respect to healthy individuals. This excess of activated CD8+ T cells correlates with the absolute CD4+ T cells.