Rui Guo,1 Fang Cheng,1 Xiang-Jie Meng,2,3 Jun-Mei Fan,4 Ya-Ling Lu,5 Xiao-Hui Ma,6 Xin Qiao,6 Jun-Hong Li7 

1Department of Ophthalmology, Children’s Hospital of Shanxi and Women Health Center of Shanxi, Affiliated to Shanxi Medical University, Taiyuan, 030000, People’s Republic of China; 2Department of Pediatric Stomatology, Shanxi Medical University School and Hospital of Stomatology, Taiyuan, 030001, People’s Republic of China; 3Department of Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Shanxi Medical University School and Hospital of Stomatology, Taiyuan, 030001, People’s Republic of China; 4Department of Reproductive Medicine Center, Children’s Hospital of Shanxi and Women Health Center of Shanxi, Affiliated to Shanxi Medical University, Taiyuan, 030000, People’s Republic of China; 5School of Basic Medicine, Shanxi Medical University, Taiyuan, 030001, People’s Republic of China; 6Department of Shanxi Province Key Laboratory of Ophthalmology, Shanxi Eye Hospital Affiliated to Shanxi Medical University, Taiyuan, 030002, People’s Republic of China; 7Department of Strabismus and Pediatric Ophthalmology, Shanxi Eye Hospital, Affiliated to Shanxi Medical University, Taiyuan, 030002, People’s Republic of China

Correspondence: Jun-Hong Li, Department of Strabismus and Pediatric Ophthalmology, Shanxi Eye Hospital Affiliated to Shanxi Medical University, No. 100 Fudong Street, Taiyuan, 030002, People’s Republic of China, Tel +8613834131099, Email junhongliljh@126.com

Objective: Our study compares immune cell profiles in preterm infants with and without severe ROP, identifying risk factors for its development to explore both immunological aspects and determinants of ROP in preterm infants.
Methods: Infants born between January 2023 to December 2023 at the Children’s Hospital of Shanxi were enrolled in this study according to the inclusion criteria. Patients were divided into a test group or a control group based on the need for Type 1 ROP treatment. Baseline data for both groups were compared. Neutrophil, lymphocyte, and monocyte subsets in the peripheral blood were analyzed using immunophenotypic analysis via multicolor flow cytometry. This method allowed for the quantification of specific cell subset proportions.
Results: A total of 2,110 preterm infants were screened for inclusion in the study. Multivariate logistic regression analysis identified gestational age below 28 weeks, birth weight less than 1,000 g, and neonatal sepsis as independent risk factors for severe ROP. Furthermore, flow cytometry analysis was performed on blood samples from 45 preterm patients. Comparative analysis revealed that the test group had a lower percentage of neutrophils and higher expression of cluster of differentiation 81 (CD81) compared to the control group. Additionally, the test group showed a higher percentage of lymphocytes and a greater proportion of Th17 cells than the control group.
Conclusion: Preterm gestational age, low birth weight, and neonatal sepsis increase severe ROP risk. Elevated CD81 and Th17 levels suggest inflammation linked to neutrophils and lymphocytes.

Keywords: flow cytometry, inflammatory response, lymphocytes, neutrophils, retinopathy of prematurity