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Nguyen TH, Kumar D, Prince C, Martini D, Grunwell JR, Lawrence T, Whitely T, Chappelle K, Chonat S, Prahalad S, Briones M, Chandrakasan S. Frequency of HLA-DR +CD38 hi T cells identifies and quantifies T-cell activation in hemophagocytic lymphohistiocytosis, hyperinflammation, and immune regulatory disorders. J Allergy Clin Immunol 2024; 153:309-319. [PMID: 37517575 PMCID: PMC10823038 DOI: 10.1016/j.jaci.2023.07.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 06/13/2023] [Accepted: 07/12/2023] [Indexed: 08/01/2023]
Abstract
BACKGROUND Quantifying T-cell activation is essential for the diagnosis and evaluation of treatment response in various hyperinflammatory and immune regulatory disorders, including hemophagocytic lymphohistiocytosis. Plasma soluble IL-2 receptor (sIL-2R) is a well-established biomarker for evaluating systemic T-cell activation. However, the limited availability of sIL-2R testing could result in delayed diagnosis. Furthermore, high sIL-2R levels may not always reflect T-cell activation. OBJECTIVES To address these limitations, this study investigated whether cell surface markers of T-cell activation, HLA-DR, and CD38, as assessed by flow cytometry, could be used to quantify systemic T-cell activation in a variety of inflammatory disease states and examine its correlation with sIL-2R levels. METHODS Results for sIL-2R, CXCL9, and ferritin assays were obtained from patient's medical records. Frequency of HLA-DR+CD38high(hi) T-cells was assessed in different T-cell subsets using flow cytometry. RESULTS In this study's cohort, activation in total CD8+ T (r = 0.65; P < .0001) and CD4+ (r = 0.42; P < .0001) T-cell subsets significantly correlated with plasma sIL-2R levels. At the disease onset, the frequency of HLA-DR+CD38hi T cells in CD8+ T (r = 0.65, P < .0001) and CD4+ T (r = 0.77; P < .0001) effector memory (TEM) compartments correlated strongly with sIL-2R levels. Evaluation of T-cell activation markers in follow-up samples also revealed a positive correlation for both CD4+ TEM and CD8+ TEM activation with sIL-2R levels; thus, attesting its utility in initial diagnosis and in evaluating treatment response. The frequency of HLA-DR+CD38hi T-cells in the CD8+ TEM compartment also correlated with plasma CXCL9 (r = 0.42; P = .0120) and ferritin levels (r = 0.32; P = .0037). CONCLUSIONS This study demonstrates that flow cytometry-based direct T-cell activation assessed by HLA-DR+CD38hi T cells accurately quantifies T-cell activation and strongly correlates with sIL-2R levels across a spectrum of hyperinflammatory and immune dysregulation disorders.
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Affiliation(s)
- Thinh H Nguyen
- Aflac Cancer and Blood Disorder Center, and the Divisions of Children's Healthcare of Atlanta, Atlanta; Department of Pediatrics, Emory University School of Medicine, Atlanta
| | - Deepak Kumar
- Aflac Cancer and Blood Disorder Center, and the Divisions of Children's Healthcare of Atlanta, Atlanta; Department of Pediatrics, Emory University School of Medicine, Atlanta
| | - Chengyu Prince
- Aflac Cancer and Blood Disorder Center, and the Divisions of Children's Healthcare of Atlanta, Atlanta
| | - Dylan Martini
- Department of Pediatrics, Emory University School of Medicine, Atlanta
| | - Jocelyn R Grunwell
- Department of Pediatrics, Emory University School of Medicine, Atlanta; Critical Care Medicine, Children's Healthcare of Atlanta, Atlanta
| | - Taylor Lawrence
- Aflac Cancer and Blood Disorder Center, and the Divisions of Children's Healthcare of Atlanta, Atlanta
| | - Trenton Whitely
- Aflac Cancer and Blood Disorder Center, and the Divisions of Children's Healthcare of Atlanta, Atlanta
| | - Karin Chappelle
- Aflac Cancer and Blood Disorder Center, and the Divisions of Children's Healthcare of Atlanta, Atlanta
| | - Satheesh Chonat
- Aflac Cancer and Blood Disorder Center, and the Divisions of Children's Healthcare of Atlanta, Atlanta; Department of Pediatrics, Emory University School of Medicine, Atlanta
| | - Sampath Prahalad
- Department of Pediatrics, Emory University School of Medicine, Atlanta; Pediatric Rheumatology, Children's Healthcare of Atlanta, Atlanta
| | - Michael Briones
- Aflac Cancer and Blood Disorder Center, and the Divisions of Children's Healthcare of Atlanta, Atlanta; Department of Pediatrics, Emory University School of Medicine, Atlanta
| | - Shanmuganathan Chandrakasan
- Aflac Cancer and Blood Disorder Center, and the Divisions of Children's Healthcare of Atlanta, Atlanta; Department of Pediatrics, Emory University School of Medicine, Atlanta.
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Chen R, Lin Q, Zhu Y, Shen Y, Xu Q, Tang H, Cui N, Jiang L, Dai X, Chen W, Li X. Sintilimab treatment for chronic active Epstein-Barr virus infection and Epstein-Barr virus-associated hemophagocytic lymphohistiocytosis in children. Orphanet J Rare Dis 2023; 18:297. [PMID: 37736751 PMCID: PMC10514962 DOI: 10.1186/s13023-023-02861-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 08/20/2023] [Indexed: 09/23/2023] Open
Abstract
BACKGROUND Chronic active Epstein-Barr virus infection (CAEBV) and Epstein-Barr virus-associated hemophagocytic lymphohistiocytosis (EBV-HLH) are rare but life-threatening progressive diseases triggered by EBV infection. Glucocorticoid/immunosuppressants treatment is temporarily effective; however, most patients relapse and/or progress. Hematopoietic stem cell transplantation (HSCT) is a potentially curative therapy; however, there are risks of transplantation-associated complications. Currently there is no standard treatment for CAEBV and EBV-HLH. Programmed death protein 1 (PD-1) inhibitors have achieved a high response in many EBV-related diseases. Sintilimab (a recombinant human IgG4 monoclonal antibody against PD-1) disrupts the interaction between PD-1 and its ligand, leading to T cell reinvigoration. METHODS A retrospective analysis was performed on three children with CAEBV or EBV-HLH in the Children's Hospital of Soochow University between 12 December 2020 and 28 November 2022. The efficacy of sintilimab was evaluated. RESULTS Three patients, including two males and one female, were analyzed. Among them, two children were diagnosed with CAEBV with intermittent fever for more than four years, and one child was diagnosed with EBV-HLH. After sintilimab treatment and a mean follow-up of 17.1 months (range 10.0-23.3 months), patients 1 and 3 achieved a complete clinical response and patient 2 achieved a partial clinical response. All three children showed a > 50% decrease in EBV-DNA load in both blood and plasma. EBV-DNA copies in sorted T, B, and NK cells were also markedly decreased after sintilimab treatment. CONCLUSION Our data supported the efficacy of PD-1 targeted therapy in certain patients with CAEBV and EBV-HLH, and suggested that sintilimab could provide a cure for these diseases, without HSCT. More prospective studies and longer follow-up are needed to confirm these conclusions.
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Affiliation(s)
- Ruyue Chen
- Department of Nephrology and Immunology, Children's Hospital of Soochow University, No.303 Jing De Road, Gusu District, Suzhou, 215002, Jiangsu, China
| | - Qiang Lin
- Department of Nephrology and Immunology, Children's Hospital of Soochow University, No.303 Jing De Road, Gusu District, Suzhou, 215002, Jiangsu, China
| | - Yun Zhu
- Department of Nephrology and Immunology, Children's Hospital of Soochow University, No.303 Jing De Road, Gusu District, Suzhou, 215002, Jiangsu, China
| | - Yunyan Shen
- Department of Nephrology and Immunology, Children's Hospital of Soochow University, No.303 Jing De Road, Gusu District, Suzhou, 215002, Jiangsu, China
| | - Qinying Xu
- Department of Nephrology and Immunology, Children's Hospital of Soochow University, No.303 Jing De Road, Gusu District, Suzhou, 215002, Jiangsu, China
| | - Hanyun Tang
- Department of Nephrology and Immunology, Children's Hospital of Soochow University, No.303 Jing De Road, Gusu District, Suzhou, 215002, Jiangsu, China
| | - Ningxun Cui
- Department of Nephrology and Immunology, Children's Hospital of Soochow University, No.303 Jing De Road, Gusu District, Suzhou, 215002, Jiangsu, China
| | - Lu Jiang
- Department of Nephrology and Immunology, Children's Hospital of Soochow University, No.303 Jing De Road, Gusu District, Suzhou, 215002, Jiangsu, China
| | - Xiaomei Dai
- Department of Nephrology and Immunology, Children's Hospital of Soochow University, No.303 Jing De Road, Gusu District, Suzhou, 215002, Jiangsu, China
| | - Weiqing Chen
- Department of Nephrology and Immunology, Children's Hospital of Soochow University, No.303 Jing De Road, Gusu District, Suzhou, 215002, Jiangsu, China
| | - Xiaozhong Li
- Department of Nephrology and Immunology, Children's Hospital of Soochow University, No.303 Jing De Road, Gusu District, Suzhou, 215002, Jiangsu, China.
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Liu M, Wang R, Xie Z. T cell-mediated immunity during Epstein-Barr virus infections in children. INFECTION, GENETICS AND EVOLUTION : JOURNAL OF MOLECULAR EPIDEMIOLOGY AND EVOLUTIONARY GENETICS IN INFECTIOUS DISEASES 2023; 112:105443. [PMID: 37201619 DOI: 10.1016/j.meegid.2023.105443] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 04/25/2023] [Accepted: 05/15/2023] [Indexed: 05/20/2023]
Abstract
Epstein-Barr virus (EBV) infection is extremely common worldwide, with approximately 90% of adults testing positive for EBV antibodies. Human are susceptible to EBV infection, and primary EBV infection typically occurs early in life. EBV infection can cause infectious mononucleosis (IM) as well as some severe non-neoplastic diseases, such as chronic active EBV infection (CAEBV) and EBV-associated hemophagocytic lymphohistiocytosis (EBV-HLH), which can have a heavy disease burden. After primary EBV infection, individuals develop robust EBV-specific T cell immune responses, with EBV-specific CD8+ and part of CD4+ T cells functioning as cytotoxic T cells, defending against virus. Different proteins expressed during EBV's lytic replication and latent proliferation can cause varying degrees of cellular immune responses. Strong T cell immunity plays a key role in controlling infection by decreasing viral load and eliminating infected cells. However, the virus persists as latent infection in EBV healthy carriers even with robust T cell immune response. When reactivated, it undergoes lytic replication and then transmits virions to a new host. Currently, the relationship between the pathogenesis of lymphoproliferative diseases and the adaptive immune system is still not fully clarified and needs to be explored in the future. Investigating the T cell immune responses evoked by EBV and utilizing this knowledge to design promising prophylactic vaccines are urgent issues for future research due to the importance of T cell immunity.
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Affiliation(s)
- Mengjia Liu
- Beijing Key Laboratory of Pediatric Respiratory Infectious Diseases, Key Laboratory of Major Diseases in Children, Ministry of Education, National Clinical Research Center for Respiratory Diseases, Laboratory of Infection and Virology, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China; Research Unit of Critical Infection in Children, Chinese Academy of Medical Sciences, Beijing 100045, China
| | - Ran Wang
- Beijing Key Laboratory of Pediatric Respiratory Infectious Diseases, Key Laboratory of Major Diseases in Children, Ministry of Education, National Clinical Research Center for Respiratory Diseases, Laboratory of Infection and Virology, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China; Research Unit of Critical Infection in Children, Chinese Academy of Medical Sciences, Beijing 100045, China.
| | - Zhengde Xie
- Beijing Key Laboratory of Pediatric Respiratory Infectious Diseases, Key Laboratory of Major Diseases in Children, Ministry of Education, National Clinical Research Center for Respiratory Diseases, Laboratory of Infection and Virology, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China; Research Unit of Critical Infection in Children, Chinese Academy of Medical Sciences, Beijing 100045, China.
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Yang P, Sun Y, Zhang M, Hu L, Wang X, Luo L, Qiao C, Wang J, Xiao H, Li X, Feng J, Chen Y, Zheng Y, Shi Y, Chen G. The inhibition of CD4
+
T cell proinflammatory response by lactic acid is independent of monocarboxylate transporter 1. Scand J Immunol 2021. [DOI: 10.1111/sji.13103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Peng Yang
- Inner Mongolia Key Lab of Molecular Biology School of Basic Medical Sciences Inner Mongolia Medical University Hohhot China
- State Key Laboratory of Toxicology and Medical CountermeasuresInstitute of Pharmacology and Toxicology Beijing China
| | - Ying Sun
- Inner Mongolia Key Lab of Molecular Biology School of Basic Medical Sciences Inner Mongolia Medical University Hohhot China
- State Key Laboratory of Toxicology and Medical CountermeasuresInstitute of Pharmacology and Toxicology Beijing China
| | - Min Zhang
- State Key Laboratory of Toxicology and Medical CountermeasuresInstitute of Pharmacology and Toxicology Beijing China
| | - Linhan Hu
- Inner Mongolia Key Lab of Molecular Biology School of Basic Medical Sciences Inner Mongolia Medical University Hohhot China
| | - Xinwei Wang
- Inner Mongolia Key Lab of Molecular Biology School of Basic Medical Sciences Inner Mongolia Medical University Hohhot China
| | - Longlong Luo
- State Key Laboratory of Toxicology and Medical CountermeasuresInstitute of Pharmacology and Toxicology Beijing China
| | - Chunxia Qiao
- State Key Laboratory of Toxicology and Medical CountermeasuresInstitute of Pharmacology and Toxicology Beijing China
| | - Jing Wang
- State Key Laboratory of Toxicology and Medical CountermeasuresInstitute of Pharmacology and Toxicology Beijing China
| | - He Xiao
- State Key Laboratory of Toxicology and Medical CountermeasuresInstitute of Pharmacology and Toxicology Beijing China
| | - Xinying Li
- State Key Laboratory of Toxicology and Medical CountermeasuresInstitute of Pharmacology and Toxicology Beijing China
| | - Jiannan Feng
- State Key Laboratory of Toxicology and Medical CountermeasuresInstitute of Pharmacology and Toxicology Beijing China
| | - Yu Chen
- Department of Experimental Animals Zhejiang Academy of Traditional Chinese Medicine Hangzhou China
| | - Yuanqiang Zheng
- Inner Mongolia Key Lab of Molecular Biology School of Basic Medical Sciences Inner Mongolia Medical University Hohhot China
| | - Yanchun Shi
- Inner Mongolia Key Lab of Molecular Biology School of Basic Medical Sciences Inner Mongolia Medical University Hohhot China
| | - Guojiang Chen
- State Key Laboratory of Toxicology and Medical CountermeasuresInstitute of Pharmacology and Toxicology Beijing China
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Kelkar MG, Bargir UA, Malik-Yadav R, Gupta M, Dalvi A, Jodhawat N, Shinde S, Madkaikar MR. CD8 + T Cells Exhibit an Exhausted Phenotype in Hemophagocytic Lymphohistiocytosis. J Clin Immunol 2021; 41:1794-1803. [PMID: 34389889 DOI: 10.1007/s10875-021-01109-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 07/22/2021] [Indexed: 12/31/2022]
Abstract
PURPOSE Hemophagocytic lymphohistiocytosis (HLH) is a hyperinflammatory syndrome mainly caused by uncontrolled activation of antigen presenting cells and CD8 T cells. CD8 T cell exhaustion is a known phenomenon in chronic viral infections and cancer. However, the role of T cell exhaustion is not yet identified in HLH in the background of persistent inflammation. So, currently, we have characterized the CD8 T cells using flow cytometry to understand the phenomenon of exhaustion in these cells in HLH. METHODS We have comprehensively evaluated lymphocyte subsets and characterized CD8 T cells using immunophenotypic markers like PD1, TIM3, LAG3, Ki67, Granzyme B, etc. in a cohort of 21 HLH patients. Effector cytokine secretion and degranulation by CD8 T cells are also studied. RESULTS Our findings indicate skewed lymphocyte subsets and aberrantly activated CD8 T cells in HLH. CD8 T cells exhibit significantly increased expression of PD1, TIM3, and LAG3 prominently in primary HLH as compared to controls. PD1 + CD8 T cells express elevated levels of Granzyme B and Ki67. Moreover, CD8 T cells are hypofunctional as evidenced by significantly reduced cytokine secretion and compromised CD107a degranulation. CONCLUSION The study has revealed that CD8 + cytotoxic T lymphocytes from HLH patients exhibited high expression of exhaustion markers with overall impaired function. To the best of our understanding, this is the first report suggesting functional exhaustion of CD8 T cells in both primary and secondary HLH. Future studies to understand the association of exhaustion with disease outcome are needed for its probable therapeutic implementation.
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Affiliation(s)
- Madhura G Kelkar
- Department of Pediatric Immunology and Leukocyte Biology, ICMR-National Institute of Immunohaematology (NIIH), 13th Floor, NMS Building, KEM Hospital Campus, Parel, , Mumbai, 400012, India
| | - Umair Ahmad Bargir
- Department of Pediatric Immunology and Leukocyte Biology, ICMR-National Institute of Immunohaematology (NIIH), 13th Floor, NMS Building, KEM Hospital Campus, Parel, , Mumbai, 400012, India
| | - Reetika Malik-Yadav
- Department of Pediatric Immunology and Leukocyte Biology, ICMR-National Institute of Immunohaematology (NIIH), 13th Floor, NMS Building, KEM Hospital Campus, Parel, , Mumbai, 400012, India
| | - Maya Gupta
- Department of Pediatric Immunology and Leukocyte Biology, ICMR-National Institute of Immunohaematology (NIIH), 13th Floor, NMS Building, KEM Hospital Campus, Parel, , Mumbai, 400012, India
| | - Aparna Dalvi
- Department of Pediatric Immunology and Leukocyte Biology, ICMR-National Institute of Immunohaematology (NIIH), 13th Floor, NMS Building, KEM Hospital Campus, Parel, , Mumbai, 400012, India
| | - Neha Jodhawat
- Department of Pediatric Immunology and Leukocyte Biology, ICMR-National Institute of Immunohaematology (NIIH), 13th Floor, NMS Building, KEM Hospital Campus, Parel, , Mumbai, 400012, India
| | - Shweta Shinde
- Department of Pediatric Immunology and Leukocyte Biology, ICMR-National Institute of Immunohaematology (NIIH), 13th Floor, NMS Building, KEM Hospital Campus, Parel, , Mumbai, 400012, India
| | - Manisha R Madkaikar
- Department of Pediatric Immunology and Leukocyte Biology, ICMR-National Institute of Immunohaematology (NIIH), 13th Floor, NMS Building, KEM Hospital Campus, Parel, , Mumbai, 400012, India.
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Hinson AR, Patel N, Kaplan J. Hemophagocytic Lymphohistiocytosis in Langerhans Cell Histiocytosis: A Case Report and Review of the Literature. J Pediatr Hematol Oncol 2021; 43:24-27. [PMID: 31725543 PMCID: PMC7737855 DOI: 10.1097/mph.0000000000001652] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Accepted: 10/13/2019] [Indexed: 11/26/2022]
Abstract
A toddler undergoing treatment for refractory Langerhans cell histiocytosis (LCH) developed concurrent hemophagocytic lymphohistiocytosis (HLH). These are thought to be distinct histiocytic disorders, with different pathophysiologies, diagnostic criteria, and treatments. HLH in a patient with LCH is thought to be quite rare. In this report, we review the presentation of our patient, as well as review the existing literature of other pediatric patients who have been diagnosed with both LCH and HLH.
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Affiliation(s)
- Ashley R.P. Hinson
- Division of Pediatric Cancer and Blood Disorders
- Atrium Health, Levine Children’s Hospital, Charlotte, NC
| | - Niraj Patel
- Division of Immunology and Infectious Diseases
- Atrium Health, Levine Children’s Hospital, Charlotte, NC
| | - Joel Kaplan
- Division of Pediatric Cancer and Blood Disorders
- Atrium Health, Levine Children’s Hospital, Charlotte, NC
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Chikagawa Y, Hikishima K, Mizumaki H, Sugimori C, Nakagishi Y, Yachie A, Nakao S. Resolution of Epstein-Barr virus-associated hemophagocytic lymphohistiocytosis associated with rapid immune reconstruction after a single course of CHOP therapy. Int J Hematol 2020; 112:889-893. [PMID: 32725606 DOI: 10.1007/s12185-020-02946-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 07/06/2020] [Accepted: 07/14/2020] [Indexed: 11/25/2022]
Abstract
Epstein-Barr virus-associated hemophagocytic lymphohistiocytosis (EBV-HLH) is a life-threatening disease characterized by the uncontrolled proliferation of EBV-infected T/NK cells with resultant immune system failure against EBV. While a CD5-HLA-DR+CD8+ T-cell population was previously shown to be EBV-infected cells and a useful marker for monitoring the response to treatment of EBV-HLH, changes in other lymphocyte subsets associated with EBV-HLH treatments have not been closely studied. We herein report a 25-year-old woman with EBV-HLH who presented with a fever, liver failure, and pancytopenia. CD8+ T cells harbored EBV. After failing steroid pulse therapy, one course of CHOP therapy immediately improved her fever and laboratory data and reduced the population of EBV-infected cells. Although the number of EBV-infected cells increased on day 20 of CHOP, a sharp increase in NK cells and normal activated T cells ensued, and the infected cells disappeared without an additional CHOP cycle. She has maintained remission without complications. This rapid immune reconstitution has not been observed in two other patients treated with HLH-2004 protocol-like regimens including prolonged immunosuppressants and etoposide. One cycle of CHOP was thought to have induced the resolution of EBV-HLH by eliminating infected cells as well as inducing the reconstruction of anti-EBV immunity.
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Affiliation(s)
- Yui Chikagawa
- Department of Hematology, Ishikawa Prefectural Central Hospital, Kanazawa, Ishikawa, Japan
- Department of Hematology, Kanazawa University Hospital, Kanazawa, Ishikawa, Japan
| | - Kazuki Hikishima
- Department of Hematology, Ishikawa Prefectural Central Hospital, Kanazawa, Ishikawa, Japan
| | - Hiroki Mizumaki
- Department of Hematology, Kanazawa University Hospital, Kanazawa, Ishikawa, Japan
- Department of Hematology, Faculty of Medicine, Institute of Medical Pharmaceutical and Health Sciences, Kanazawa, Ishikawa, Japan
| | - Chiharu Sugimori
- Department of Hematology, Ishikawa Prefectural Central Hospital, Kanazawa, Ishikawa, Japan
| | - Yasuo Nakagishi
- Department of Pediatric Rheumatology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Hyogo, Japan
| | - Akihiro Yachie
- Division of Medical Safety, Kanazawa University Hospital, Kanazawa, Ishikawa, Japan
| | - Shinji Nakao
- Department of Hematology, Faculty of Medicine, Institute of Medical Pharmaceutical and Health Sciences, Kanazawa, Ishikawa, Japan.
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Klatka J, Hymos A, Szkatuła-Łupina A, Grywalska E, Klatka B, Terpiłowski M, Stepulak A. T-Lymphocyte Activation Is Correlated With the Presence of Anti-EBV in Patients With Laryngeal Squamous Cell Carcinoma. In Vivo 2020; 33:2007-2012. [PMID: 31662531 DOI: 10.21873/invivo.11697] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 07/25/2019] [Accepted: 07/30/2019] [Indexed: 12/27/2022]
Abstract
BACKGROUND/AIM Chronic viral infection is an important risk factor in the development of cancer. Failure of immune response to clear the oncogenic infection can facilitate cancer progression. The aim of the present study was to analyze early and late activation of T-lymphocytes related to Epstein-Barr virus (EBV) infection by the expression of markers of activation (CD69, CD25) on the surface of T-lymphocytes (CD3+, CD4+, CD8+) in patients bearing laryngeal cancer according to absence/presence immunoglobulin G antibodies to EBV nuclear antigen (EBNA1). MATERIALS AND METHODS Thirty-three patients with laryngeal squamous cell carcinoma (LC) and 20 volunteers without cancer (control group) were enrolled in the study. Peripheral blood samples were collected from every individual. The markers of activation of T-lymphocytes were determined by flow cytometry, whereas commercial immunoenzymatic assay kits were used for detection of anti-viral capsid antigen (VCA) IgM, anti-VCA IgG, and anti-EBNA1 IgG. RESULTS Increased early activation of CD8+ and CD4+ T-lymphocytes was found in patients with LC. There was a significantly higher proportion of CD4+ and CD8+T-lymphocytes expressing CD69 antigen in patients with LC compared to the control group. The proportion of CD4+ CD25+ T-lymphocytes in patients with LC positive for anti-EBNA1 IgG and anti-VCA IgM was lower compared to patients without antibodies to VCA IgM. CONCLUSION The dysfunction of immune response in larynx cancer patients could be associated with EBV infection.
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Affiliation(s)
- Janusz Klatka
- Department of Otolaryngology and Laryngeal Oncology, Medical University of Lublin, Lublin, Poland
| | - Anna Hymos
- Department of Otolaryngology and Laryngeal Oncology, Medical University of Lublin, Lublin, Poland
| | - Anna Szkatuła-Łupina
- Department of Otolaryngology and Laryngeal Oncology, Medical University of Lublin, Lublin, Poland
| | - Ewelina Grywalska
- Department of Clinical Immunology and Immunotherapy, Medical University of Lublin, Lublin, Poland
| | - Barbara Klatka
- Department of Otolaryngology and Laryngeal Oncology, Medical University of Lublin, Lublin, Poland
| | - Michał Terpiłowski
- Department of Otolaryngology and Laryngeal Oncology, Medical University of Lublin, Lublin, Poland
| | - Andrzej Stepulak
- Department of Biochemistry and Molecular Biology, Medical University of Lublin, Lublin, Poland
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Hou H, Luo Y, Wang F, Yu J, Li D, Sun Z. Evaluation of lymphocyte function by IFN-γ secretion capability assay in the diagnosis of lymphoma-associated hemophagocytic syndrome. Hum Immunol 2019; 80:1006-1011. [PMID: 31540793 DOI: 10.1016/j.humimm.2019.09.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2019] [Revised: 07/30/2019] [Accepted: 09/03/2019] [Indexed: 11/26/2022]
Abstract
Lymphoma-associated hemophagocytic syndrome (LAHS) is a highly life-threatening disease characterized by an uncontrolled immune disorder. Both under-recognition and delayed diagnosis may contribute to aggressive diseases, and a poorer prognosis. Identification of laboratory features specific for LAHS patients may allow for early detection and intervention with improved outcomes. In the present study, 120 lymphoma patients at first diagnosis were recruited and the function of lymphocytes was evaluated by IFN-γ secretion assay at first diagnosis and follow up. During the surveillance period, 20 patients who complicated with hemophagocytic lymphohistiocytosis (HLH) were classified as LAHS group, and 30 patients without infectious diseases during the course of treatment were classified as lymphoma control group. In addition, 20 non-malignant associated HLH patients recruited as HLH control group and 50 healthy control (HC) subjects were also included. The IFN-γ secretion capability of lymphocytes was compared between first diagnosis of lymphoma patients who was complicate with HLH or not in the disease progression. Our results showed that only NK cell activity was decreased in lymphoma control group, but the activities of NK, CD4+ and CD8+ T cells were all significantly decreased at the time of lymphoma diagnosis in those who would progress with HLH. During the course of treatment, lymphocyte function was relatively stable in lymphoma patients but became further decreased when suffering from complication of LAHS. The IFN-γ secretion capability of lymphocytes in LAHS and non-malignant associated HLH patients were all significantly decreased compared with HCs. So the occurrence of HLH was the key factor leading to the impaired activity of lymphocytes. These data suggest that decreased lymphocyte function might be used as a predictor of LAHS, which has critical clinical significance in diagnosis and further understanding the pathogenesis of the disease.
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Affiliation(s)
- Hongyan Hou
- Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Road 1095#, Wuhan, China
| | - Ying Luo
- Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Road 1095#, Wuhan, China
| | - Feng Wang
- Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Road 1095#, Wuhan, China
| | - Jing Yu
- Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Road 1095#, Wuhan, China
| | - Dengju Li
- Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Road 1095#, Wuhan, China.
| | - Ziyong Sun
- Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Road 1095#, Wuhan, China.
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