Eculizumab treatment modifies the immune profile of PNH patients.
Paroxysmal Nocturnal Haemoglobinuria (PNH) is due to pathological expansion of a stem progenitor bearing a somatic mutation of PIG-A gene involved in the biosynthesis of the glycosyl-phosphatidyl-inositol (GPI) anchor. Numerous data suggest a role for immune-mediated mechanisms in the selection/expansion of GPI-defective clone. Haemolytic anaemia in PNH is dependent on the effect of complement against GPI-defective red cells. Eculizumab, an anti-C5 monoclonal antibody, is dramatically effective in controlling haemolysis and thrombosis, in reducing fatigue and in improving quality of life of patients. However, this therapy presents new challenges that need to be properly faced. Here, we report the decrease in B, Natural Killer (NK) and regulatory T cells (Treg), an altered cytokine profile of invariant-NKT cells (NKTi) and the increasing of C-X-C chemokine receptor type 4 (CXCR4) receptor in PNH patients before the Eculizumab therapy. Treatment significantly affects some of these alterations: after Eculizumab, the number of B lymphocytes, the cytokine secretion of NKTi and CXCR4 expression on CD8 T cells became similar to healthy donors. No effects were observed on NK and Treg. The amplitude of the GPI-defective compartment remained unchanged.
Department of Biochemistry and Biomedical Technologies, University of Naples Federico II, Italy.
Fiorella
F
Alfinito
Giuseppina
G
Ruggiero
Michela
M
Sica
Annapoorani
A
Udhayachandran
Valentina
V
Rubino
Roberta
R
Della Pepa
Anna T
AT
Palatucci
Mariangela
M
Annunziatella
Rosario
R
Notaro
Antonio M
AM
Risitano
Giuseppe
G
Terrazzano
D000328:Adult; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage / Q000276:immunology / Q000627:therapeutic use*; D001402:B-Lymphocytes / Q000276:immunology* / Q000473:pathology; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology* / Q000473:pathology; D002452:Cell Count; D003165:Complement System Proteins / Q000276:immunology; D016207:Cytokines / Q000096:biosynthesis / Q000276:immunology; D004912:Erythrocytes / Q000276:immunology / Q000473:pathology; D005260:Female; D015870:Gene Expression; D017261:Glycosylphosphatidylinositols / Q000235:genetics / Q000276:immunology; D006457:Hemoglobinuria, Paroxysmal / Q000188:drug therapy* / Q000276:immunology / Q000473:pathology; D006461:Hemolysis; D006801:Humans; D008297:Male; D008565:Membrane Proteins / Q000235:genetics / Q000276:immunology; D008875:Middle Aged; D055611:Natural Killer T-Cells / Q000276:immunology* / Q000473:pathology; D019718:Receptors, CXCR4 / Q000235:genetics / Q000276:immunology; D050378:T-Lymphocytes, Regulatory / Q000276:immunology* / Q000473:pathology
D061067:Antibodies, Monoclonal, Humanized; C527276:CXCR4 protein, human; D016207:Cytokines; D017261:Glycosylphosphatidylinositols; D008565:Membrane Proteins; D019718:Receptors, CXCR4; C080086:phosphatidylinositol glycan-class A protein; D003165:Complement System Proteins; C481642:eculizumab