Growth hormone (GH)-induced reconstitution of CD8+ CD28+ T lymphocytes in a rare case of severe lymphopenia associated with Juvenile Haemochromatosis and Turner's syndrome.
This paper describes a rare case of Turner's syndrome associated with Juvenile Haemochromatosis and severe lymphopenia, followed-up for a period of 5 years. Because of the indication for treatment with growth hormone (GH), this case was observed as a model to analyse the effects of GH on growth, iron mobilization and lymphocyte reconstitution. For this purpose, a serial study of the T lymphocyte subpopulations CD4+, CD8+, CD8+ CD28+ and CD8+ CD28- was performed by immunophenotyping during the follow-up period. Besides the impact of both phlebotomy treatment and GH on the rapid growth and mobilization of 20.8 g of iron in 136 weeks, the most relevant observation was the finding of a significant expansion of CD8+ T lymphocytes expressing the costimulatory marker CD28 in the setting of the severe lymphopenia. These findings constitute new clinical evidence supporting the notion that the GH/IGF-1 system has an important role on the maintenance of T cell homeostasis in vivo, and that GH may be regarded as a putative therapeutic agent in T lymphocyte reconstitution.
Santo António General Hospital, Porto, Portugal. gporto@ibmc.up.pt
Graça
G
Porto
Eugénia
E
Cruz
Helena Pessegueiro
HP
Miranda
Beatriz
B
Porto
José Carlos
JC
Vasconcelos
Rosa
R
Lacerda
Antonella
A
Roetto
Filomena
F
Daraio
Conceição
C
Bacelar
D000293:Adolescent; D018106:CD28 Antigens / Q000276:immunology; D018414:CD8-Positive T-Lymphocytes / Q000187:drug effects* / Q000276:immunology; D005260:Female; D005500:Follow-Up Studies; D006432:Hemochromatosis / Q000150:complications / Q000276:immunology* / Q000628:therapy; D019382:Human Growth Hormone / Q000627:therapeutic use*; D006801:Humans; D016130:Immunophenotyping; D007501:Iron / Q000378:metabolism; D018655:Lymphocyte Count; D008231:Lymphopenia / Q000150:complications / Q000276:immunology* / Q000628:therapy; D018962:Phlebotomy; D014424:Turner Syndrome / Q000150:complications / Q000276:immunology* / Q000628:therapy
D018106:CD28 Antigens; D019382:Human Growth Hormone; D007501:Iron