Clinical Factors of Blood Transfusion-Related Acute Lung Injury and Changes in Levels of Treg-Related Cytokines

OBJECTIVE: Analysis of clinical factors and changes in regulatory T cell (Treg)-related cytokine levels in transfusion-associated acute lung injury (TRALI). METHODS: 62 patients who underwent blood transfusion and developed TRALI (TRALI group) in our hospital between January 2018 and December 2021 and 58 patients who did not develop TRALI (non-TRALI group) from blood transfusion were selected to collect clinical data from patients and construct a logistic regression model to analyze clinical risk factors for TRALI. Based on the prognosis of TRALI patients, they were divided into survival group (50 cases) and death group (12 cases), and serum CD4 + CD25 + Treg and Treg-related cytokines (interleukin 10 (IL-10), transforming growth factor-β (TGF-β)) levels were compared between the two groups, and the correlation between CD4 + CD25 + Treg and IL-10 and TGF-β was analyzed by Pearson. RESULTS: The differences in smoking history, human leukocyte antigen (HLA) antibody II, pretransfusion shock, and CD4 + CD25 + Treg between the TRALI group and non-TRALI group were statistically significant (P < 0.05). Logistic regression analysis showed that HLA antibody II and increased CD4 + CD25 + Treg were independent risk factors of TRALI (P < 0.05). The levels of CD4 + CD25 + Treg, IL-10, and TGF-β in the death group were significantly higher than those in the survival group (P < 0.05). CD4 + CD25 + Treg was positively correlated with levels of IL-10 and TGF-β (P < 0.05). CONCLUSION: Elevated HLA antibody II and CD4 + CD25 + Treg are the main clinical risk factors for TRALI, and CD4 + CD25 + Treg may be involved in immunosuppression by increasing the expression levels of IL-10 and TGF-β. Early clinical monitoring of changes in Treg-related cytokine levels can provide some guidance for prognostic assessment of TRALI patients.