Stem/progenitor cell-driven immune microenvironment remodeling in sepsis-associated acute respiratory distress syndrome

doi:10.4252/wjsc.121124

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World Journal of Stem Cells

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1948-0210

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Stem Cells. Aug 26, 2026; 18(8): 121124
Published online Aug 26, 2026. doi: 10.4252/wjsc.121124

Table 1 General information and disease severity of two groups, n (%)/mean ± SD

Indicators	Moderate group (n = 111)	Severe group (n = 89)	Statistical values	P value
Gender			χ² = 0.002	0.964
Male	77 (69.37)	62 (69.66)
Female	34 (30.63)	27 (30.34)
History of COPD	16 (14.41)	17 (19.10)	χ² = 0.788	0.375
Diabetes	30 (27.03)	34 (38.20)	χ² = 2.835	0.092
Chronic kidney disease	9 (8.11)	24 (26.97)	χ² = 12.750	< 0.001
Immunosuppressive state	7 (6.31)	10 (11.24)	χ² = 1.543	0.214
Age (years)	64.34 ± 11.14	66.97 ± 8.74	t = 1.822	0.070
SOFA score	8.81 ± 2.12	10.59 ± 2.39	t = 5.575	< 0.001
APACHE II score	19.45 ± 4.60	23.70 ± 5.91	t = 5.719	< 0.001
PaO₂/FiO₂ (mmHg)	150.97 ± 24.20	91.12 ± 10.55	t = 21.727	< 0.001
Blood lactic acid (mmol/L) on the first day of ICU admission	2.65 ± 0.93	3.62 ± 1.13	t = 6.659	< 0.001
Mechanical ventilation time (days)	8.24 ± 4.44	12.43 ± 5.57	t = 5.920	< 0.001
ICU stay (days)	11.77 ± 5.87	15.46 ± 6.40	t = 4.244	< 0.001

COPD: Chronic obstructive pulmonary disease; SOFA: Sequential organ failure assessment; APACHE II: Acute physiology and chronic health evaluation II; ICU: Intensive care unit.

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Table 2 Comparison of alveolar epithelial type II cells progenitor cell-related indicators in bronchoalveolar lavage fluid, mean ± SD

Indicators	Moderate group (n = 111)	Severe group (n = 89)	t	P value
Relative expression of SFTPC (2^-ΔΔCt)	0.81 ± 0.20	0.55 ± 0.20	9.137	< 0.001
Proportion of EPCAM positive (%)	0.88 ± 0.26	0.63 ± 0.19	7.589	< 0.001
Proportion of CD44 positive (%)	0.92 ± 0.32	1.15 ± 0.26	5.483	< 0.001

SFTPC: Surfactant protein C; EPCAM: Epithelial cell adhesion molecule.

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Table 3 Imbalance of immune microenvironment and changes of inflammatory factors, mean ± SD

Indicators	Moderate group (n = 111)	Severe group (n = 89)	t	P value
Th17/Treg ratio	1.38 (1.18-1.74)	2.05 (1.73-2.54)	-7.842	< 0.001
CD4+T cell ratio (%)	41.88 ± 6.68	35.49 ± 7.86	6.213	< 0.001
CD8+T cell ratio (%)	26.38 ± 5.68	29.02 ± 5.47	3.321	0.001
IL-6 (pg/mL)	101.70 (75.17-135.41)	183.11 (143.88-245.16)	-8.156	< 0.001
TNF-α (pg/mL)	28.93 (25.96-36.76)	40.82 (32.90-54.50)	-6.734	< 0.001
IL-10 (pg/mL)	13.86 (10.65-19.34)	15.64 (13.03-22.77)	-1.982	0.049

Th17: T helper 17 cell; Treg: Regulatory T cells; IL: Interleukin; TNF-α: Tumor necrosis factor-α.

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Table 4 Comparison of clinical outcomes between the two groups, n (%)/mean ± SD

Outcome indicators	Moderate group (n = 111)	Severe group (n = 89)	Statistical values	P value
28 days of death	20 (18.02)	47 (52.81)	χ² = 26.838	< 0.001
Mechanical ventilation time (days)	8.24 ± 4.44	12.43 ± 5.57	t = 5.920	< 0.001
ICU stay (days)	11.77 ± 5.87	15.46 ± 6.40	t = 4.244	< 0.001

ICU: Intensive care unit.

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Table 5 Multivariate logistic regression analysis of 28 days death

Variable	β	SE	Wald χ²	OR	95%CI	P value
Severe	-0.274	0.595	0.213	0.76	0.23-2.46	0.641
Lactic acid	0.299	0.210	2.031	1.35	0.89-2.03	0.156
SOFA	0.286	0.102	7.863	1.33	1.09-1.62	0.005
SFTPC	-3.507	1.132	9.603	0.03	0.00-0.26	0.002
LogTh17/Treg	1.368	0.745	3.371	3.93	0.91-16.93	0.066
Constant term	-4.826	1.894	6.497	0.008	-	0.011

OR: Odds ratio; CI: Confidence interval; SOFA: Sequential organ failure assessment; SFTPC: Surfactant protein C; Th17: T helper 17 cell; Treg: Regulatory T cells.

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Citation: Li WX, Jiang SC, Fan SL, Xing YX, Gong L. Stem/progenitor cell-driven immune microenvironment remodeling in sepsis-associated acute respiratory distress syndrome. World J Stem Cells 2026; 18(8): 121124
URL: https://www.wjgnet.com/1948-0210/full/v18/i8/121124.htm
DOI: https://dx.doi.org/10.4252/wjsc.121124

Li WX, Jiang SC, Fan SL, Xing YX, Gong L. Stem/progenitor cell-driven immune microenvironment remodeling in sepsis-associated acute respiratory distress syndrome. World J Stem Cells 2026; 18(8): 121124 [DOI: 10.4252/wjsc.121124]

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