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Multidimensional assessment of alveolar T cells in critically ill patients
James M. Walter, … , Richard G. Wunderink, Benjamin D. Singer
James M. Walter, … , Richard G. Wunderink, Benjamin D. Singer
Published September 6, 2018
Citation Information: JCI Insight. 2018;3(17):e123287. https://doi.org/10.1172/jci.insight.123287.
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Resource and Technical Advance Immunology Pulmonology

Multidimensional assessment of alveolar T cells in critically ill patients

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Abstract

Pneumonia represents the leading infectious cause of death in the United States. Foxp3+ regulatory T cells promote recovery from severe pneumonia in mice, but T cell responses in patients with pneumonia remain incompletely characterized because of the limited ability to serially sample the distal airspaces and perform multidimensional molecular assessments on the small numbers of recovered cells. As T cell function is governed by their transcriptional and epigenetic landscape, we developed a method to safely perform high-resolution transcriptional and DNA methylation profiling of T cell subsets from the alveoli of critically ill patients. Our method involves nonbronchoscopic bronchoalveolar lavage combined with multiparameter fluorescence-activated cell sorting, unsupervised low-input RNA-sequencing, and a modified reduced-representation bisulfite sequencing protocol. Here, we demonstrate the safety and feasibility of our method and use it to validate functional genomic elements that were predicted by mouse models. Because of its potential for widespread application, our techniques allow unprecedented insights into the biology of human pneumonia.

Authors

James M. Walter, Kathryn A. Helmin, Hiam Abdala-Valencia, Richard G. Wunderink, Benjamin D. Singer

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Figure 1

Nonbronchoscopic BAL (NBBAL) technique and T cell sorting procedure.

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Nonbronchoscopic BAL (NBBAL) technique and T cell sorting procedure.
(A)...
(A) Schematic representation of the NBBAL procedure. (B) BAL fluid cell characteristics from a 5-year review of 2,695 consecutive NBBALs performed at our institution. (C) Fluorescence-activated cell sorting strategy used to obtain purified regulatory T (Treg) and effector-memory T (Teff-mem) cells from BAL fluid. The percentage of cells in the indicated gate is shown for a representative sample. (D) Sorted Teff-mem and Treg cell numbers used for downstream next-generation sequencing. (E) Nucleic acid mass purified from sorted Teff-mem and Treg cells. Lines represent mean values. Data in D and E represent 3 replicates for each cell type obtained from 3 individual participants. SSC-A, side scatter area; FSC-A, forward scatter area; FSC-H, forward scatter height; see Supplemental Table 2 for fluorochrome abbreviations.

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