title: CD4+ T-lymphocytopenia and systemic immune activation in patients with primary and secondary liver tumours.
abstract: Using flow cytometry, we evaluated peripheral blood leucocyte subsets in 84 patients with primary and secondary liver cancer. The patients had significantly lower absolute (659+/-386 vs. 906+/-360 cells per microl, p=0.004) numbers of CD3+ CD4+, relative (9+/-5 vs. 12+/-4%, p=0.02) and absolute (154+/-115 vs. 221+/-83 cells per microl, p=0.02) numbers of CD8+ CD28+, absolute numbers of CD3+ and relative and absolute numbers of CD19+. Relative and absolute numbers of CD3+ DR+, CD3+ CD69+ and CD14+ CD16+ cells were significantly elevated in patients compared to controls. The phenotype was similar in 54 patients exposed to chemotherapy compared to 30 untreated patients. Urinary neopterin, a marker of systemic immune activation, was significantly higher in patients with liver tumours compared to controls. A negative correlation was observed between urinary neopterin and the absolute numbers of CD3+ CD4+ (Spearman rank correlation coefficient, rs = -0.54, p<0.0025) and CD19+ (rs = -0.49, p<0.01) in untreated patients. We conclude that, independently of prior chemotherapy, patients with liver present with markedly decreased numbers of CD3+ CD4+ lymphocytes as well as with other abnormalities of peripheral blood leukocyte phenotype. Similar to patients with human immunodeficiency virus infection, the decrease in CD3+ CD4+ lymphocytes is associated with systemic immune activation.
authors.affiliation: Department Oncology and Radiotherapy, Charles University Medical School and Teaching Hospital, Hradec Králové, Czech Republic. Bohuslav.Melichar@worldonline.cz
authors.forename: B
authors.initials: B
authors.lastname: Melichar
authors.forename: M
authors.initials: M
authors.lastname: Tousková
authors.forename: D
authors.initials: D
authors.lastname: Solichová
authors.forename: P
authors.initials: P
authors.lastname: Králicková
authors.forename: G
authors.initials: G
authors.lastname: Kopecký
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000652:urine; D017252:CD3 Complex / Q000032:analysis; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D016130:Immunophenotyping; D008113:Liver Neoplasms / Q000276:immunology* / Q000556:secondary; D018655:Lymphocyte Count; D008214:Lymphocytes / Q000276:immunology; D008231:Lymphopenia / Q000150:complications*; D008297:Male; D008875:Middle Aged; D019798:Neopterin / Q000652:urine
chemical_list: D015415:Biomarkers; D017252:CD3 Complex; D019798:Neopterin