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Rybicka-Ramos M, Markiewicz M, Suszka-Świtek A, Wiaderkiewicz R, Mizia S, Dzierżak-Mietła M, Białas K. Profiles of interferon-gamma and interleukin-2 in patients after allogeneic hematopoietic stem cell transplantation. World J Biol Chem 2022; 13:72-82. [PMID: 36187719 PMCID: PMC9521416 DOI: 10.4331/wjbc.v13.i4.72] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 05/11/2022] [Accepted: 09/21/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Allogeneic hematopoietic stem cell transplantation (allo-HSCT) may be related to the occurrence of complications, including graft-versus-host disease (GvHD) and infections. The pathogenesis of acute GvHD is connected with T lymphocytes, which identify alloantigens on host's antigen-presenting cells, activate production of interferon-gamma (IFN-gamma) and interleukin-2 (IL-2), and act on the immune effector cells and damage tissues and organs.
AIM The aim of the study was to investigate and distinguish serum concentration profiles of IFN-gamma and IL-2 within a 30-d period after allo-HSCT.
METHODS We enrolled 62 patients, i.e., 30 (48%) male and 32 (52%) female subjects [median age 49.5 (19-68) years], after allo-HSCT from siblings (n = 12) or unrelated donors (n = 50) due to acute myeloid leukemia with myeloablative conditioning (n = 26; 42%) and with non-myeloablative conditioning (n = 36; 58%). All patients were given standard immunosuppressive therapy with cyclosporin-A and methotrexate and pre-transplant antithymocyte globulin in the unrelated setting. Blood samples were collected pre-transplant before and after (on day -1) the conditioning therapy and on days +2,+4, +6, +10, +20, and +30 after allo-HSCT. Serum levels of IL-2 and IFN-gamma were determined using ELISA.
RESULTS Patients were divided into four groups depending on the presence of acute GvHD and clinical manifestations of infection. Group I included patients with neither acute GvHD nor infections [n = 15 (24%)], group II consisted of patients with infections without acute GvHD [n = 17 (27%)], group III was comprised of patients with acute GvHD without infections [n = 9 (15%)], and group IV included patients with both acute GvHD and infections [n = 21 (34%)]. IFN-gamma concentrations were higher in Group II than in other groups on days +20 (P = 0.014) and +30 (P = 0.008). Post-hoc tests showed lower concentrations of IFN-gamma on day +30 in groups I (P = 0.039) and IV (P = 0.017) compared to group II. The levels of IL-2 were mostly undetectable.
CONCLUSION Serum levels of IFN-gamma following allo-HSCT progressively escalate. High serum levels of IFN-gamma are related to infectious complications rather than acute GvHD. Serum concentrations of IL-2 in most patients are undetectable.
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Affiliation(s)
| | - Mirosław Markiewicz
- Department of Hematology, University of Rzeszow, College of Medical Sciences, Institute of Medical Sciences, Rzeszów 35-315, Poland
| | - Aleksandra Suszka-Świtek
- Department of Histology and Embryology, School of Medicine in Katowice, Medical University of Silesia, Katowice 40-752, Poland
| | - Ryszard Wiaderkiewicz
- Department of Histology and Embryology, School of Medicine in Katowice, Medical University of Silesia, Katowice 40-752, Poland
| | - Sylwia Mizia
- Department of Population Health, Division of Epidemiology and Health Education, Wroclaw Medical University, Wrocław 51-618, Poland
| | - Monika Dzierżak-Mietła
- Department of Bone Marrow Transplantation and Hematooncology, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice 44-102, Poland
| | - Krzysztof Białas
- Department of Hematology and Bone Marrow Transplantation, SPSK-M Hospital, Katowice 40-027, Poland
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McCurdy SR, Luznik L. Immune reconstitution after T-cell replete HLA-haploidentical transplantation. Semin Hematol 2019; 56:221-226. [PMID: 31202434 DOI: 10.1053/j.seminhematol.2019.03.005] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Accepted: 03/18/2019] [Indexed: 12/19/2022]
Abstract
Impaired immune reconstitution has been one of the perceived limitations of alternative donor transplantation. However, modern transplantation platforms such as HLA-haploidentical transplantation with either post-transplantation cyclophosphamide or with anti-thymocyte globulin combined with intense immunosuppression may be associated with robust immune recovery as inferred by low rate of infectious mortality and post-transplantation lymphoproliferative disease. Here, we review the data on immune reconstitution including individual cell subsets, the effect of reconstitution on outcomes, and comparative studies using these commonly utilized T-cell replete HLA-haploidentical platforms. We find robust recovery of neutrophils, natural killer cells, CD8+ T-cells, and B-cells, with delayed CD4+ T-cell recovery comparable to that after HLA-matched transplantation. In addition, while viral reactivations and infections appear more common after HLA-haploidentical when compared with HLA-matched transplantation, infectious mortality remains low likely due to modern cytomegalovirus monitoring, preemptive treatment, as well as relative frequency of nonlethal viral infections like polyomavirus hominis 1 (BK virus). Higher graft cell doses also appear to be associated with faster recovery without concomitant increases in lethal graft-vs-host disease. Finally, despite rapid numerical return of natural killer cells post-transplant, phenotypically they retain immaturity markers till day 180 or more after transplantation, which suggests an avenue for future research to improve outcomes further.
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Affiliation(s)
- Shannon R McCurdy
- Abramson Cancer Center and the Division of Hematology and Oncology, Hospital of the University of Pennsylvania, Philadelphia, PA.
| | - Leo Luznik
- Department of Oncology and Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD
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Podgorny PJ, Pratt LM, Liu Y, Dharmani-Khan P, Luider J, Auer-Grzesiak I, Mansoor A, Williamson TS, Ugarte-Torres A, Hoegh-Petersen M, Khan FM, Larratt L, Jimenez-Zepeda VH, Stewart DA, Russell JA, Daly A, Storek J. Low Counts of B Cells, Natural Killer Cells, Monocytes, Dendritic Cells, Basophils, and Eosinophils are Associated with Postengraftment Infections after Allogeneic Hematopoietic Cell Transplantation. Biol Blood Marrow Transplant 2015; 22:37-46. [PMID: 26363444 DOI: 10.1016/j.bbmt.2015.09.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2015] [Accepted: 09/02/2015] [Indexed: 01/06/2023]
Abstract
Hematopoietic cell transplant (HCT) recipients are immunocompromised and thus predisposed to infections. We set out to determine the deficiency of which immune cell subset(s) may predispose to postengraftment infections. We determined day 28, 56, 84, and 180 blood counts of multiple immune cell subsets in 219 allogeneic transplant recipients conditioned with busulfan, fludarabine, and Thymoglobulin. Deficiency of a subset was considered to be associated with infections if the low subset count was significantly associated with subsequent high infection rate per multivariate analysis in both discovery and validation cohorts. Low counts of monocytes (total and inflammatory) and basophils, and low IgA levels were associated with viral infections. Low plasmacytoid dendritic cell (PDC) counts were associated with bacterial infections. Low inflammatory monocyte counts were associated with fungal infections. Low counts of total and naive B cells, total and CD56(high) natural killer (NK) cells, total and inflammatory monocytes, myeloid dendritic cells (MDCs), PDCs, basophils and eosinophils, and low levels of IgA were associated with any infections (due to any pathogen or presumed). In conclusion, deficiencies of B cells, NK cells, monocytes, MDCs, PDCs, basophils, eosinophils, and/or IgA plasma cells appear to predispose to postengraftment infections.
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Affiliation(s)
- Peter J Podgorny
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada.
| | - Laura M Pratt
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Yiping Liu
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | | | - Joanne Luider
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Iwona Auer-Grzesiak
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Adnan Mansoor
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada
| | | | | | | | - Faisal M Khan
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Loree Larratt
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | | | - Douglas A Stewart
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - James A Russell
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Andrew Daly
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Jan Storek
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
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