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. 2019 Aug 16;10:1954. doi: 10.3389/fimmu.2019.01954

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Copyright © 2019 Schlundt, Reinke, Geissler, Bucher, Giannini, Märdian, Dahne, Kleber, Samans, Baron, Duda, Volk and Schmidt-Bleek.

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) and the copyright owner(s) 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.

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Impaired bone healing correlates with an elevated CD8+ T_EMRA level in both the peripheral blood as well as in the local fracture hematoma of patients. (A) Results of the flow cytometry analyses of terminally differentiated CD8+ effector T cells (CD8+T_EMRA) in the peripheral blood of fracture patients at the time of operation are shown. Impaired fracture healing patients showed a significantly higher frequency of CD45+CD3+CD8+CD57+CD28- T cells (CD57+CD28-+ in % of CD45+CD3+CD8+ T cells) compared to the normal healing patients indicates a dramatic increase of CD8+ T_EMRA: n = 12 for the impaired healing group, n = 23 for the normal healing group. (B) Quantification of CD8+ T cells in the hematoma region of fracture healing patients by epigenetic qPCR analysis. Impaired fracture healing patients showed an elevated level of CD8+ T cells in the local fracture area: n = 5 for the impaired healing group, n = 3 for the normal healing group (C,D) Representative x-ray images from the study cohort over a period of 15 months including the pre-surgery as well as the 6 and 15 months post-surgery states of fracture healing of an impaired healing (C) and a normal healing (D) patient, respectively. Student's t-test.