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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 fracture healing correlates with an elevated level of CD4+ T_Reg and a higher ratio of CD8+ T_EMRA/CD4+ T_Reg. (A) Results of the flow cytometry analyses of the CD4+ T_Reg and the ratio CD8+T_EMRA/CD4+T_Reg in the peripheral blood of fracture patients at the time of operation are shown. Impaired fracture healing patients showed slightly elevated levels of CD45+CD3+CD4+CD25highCD127low T_Reg (CD25highCD127low in % of CD45+CD3+CD4+) compared to the normal healing patients indicates a partial, but not sufficient compensatory effect. The ratio of CD8+T_EMRA/CD4+T_Reg was significantly higher in patients with a delayed healing: n = 12 for the impaired healing group, n = 23 for the normal healing group. (B) Impaired fracture healing patients showed a significantly higher ratio of CD8+T cells/CD4+ T_Reg in the hematoma region demonstrating an insufficient compensatory effect of the CD4+ T_Reg in the impaired fracture healing patients: n = 5 for the impaired healing group, n = 3 for the normal healing group. Student's t-test.