title: Effect of alemtuzumab on intestinal intraepithelial lymphocytes and intestinal barrier function in cynomolgus model.
abstract: BACKGROUND
  Alemtuzumab has been used in organ transplantation and a variety of hematologic malignancies (especially for the treatment of B-cell chronic lymphocytic leukemia). However, serious infectious complications frequently occur after treatment. The reason for increased infections postalemtuzumab treatment is unknown at this stage. We explore the effect of alemtuzumab on intestinal intraepithelial lymphocytes (IELs) and intestinal barrier function in cynomolgus model to explain the reason of infection following alemtuzumab treatment.
  
  
  METHODS
  Twelve male cynomolguses were randomly assigned to either a treatment or control group. The treatment group received alemtuzumab (3 mg/kg, intravenous injection) while the control group received the same volume of physiological saline. Intestinal IELs were isolated from the control group and the treatment group (on day 9, 35, and 70 after treatment) for counting and flow cytometric analysis. Moreover, intestinal permeability was monitored by enzymatic spectrophotometric technique and enzyme-linked immunosorbent assay.
  
  
  RESULTS
  The numbers of IELs were decreased significantly on day 9 after treatment compared with the control group (0.35 ± 0.07 × 10 8 and 1.35 ± 0.09 × 10 8 , respectively; P < 0.05) and were not fully restored until day 70 after treatment. There were significant differences among four groups considering IELs subtypes. In addition, the proportion of apoptotic IELs after alemtuzumab treatment was significantly higher than in the control group (22.01 ± 3.67 and 6.01 ± 1.42, respectively; P < 0.05). Moreover, the concentration of D-lactate and endotoxin was also increased significantly on day 9 after treatment.
  
  
  CONCLUSIONS
  Alemtuzumab treatment depletes lymphocytes in the peripheral blood and intestine of cynomolgus model. The induction of apoptosis is an important mechanism of lymphocyte depletion after alemtuzumab treatment. Notably, intestinal barrier function may be disrupted after alemtuzumab treatment.
authors.forename: Lin-Lin
authors.initials: LL
authors.lastname: Qu
authors.forename: Ya-Qing
authors.initials: YQ
authors.lastname: Lyu
authors.forename: Hai-Tao
authors.initials: HT
authors.lastname: Jiang
authors.forename: Ting
authors.initials: T
authors.lastname: Shan
authors.forename: Jing-Bin
authors.initials: JB
authors.lastname: Zhang
authors.forename: Qiu-Rong
authors.initials: QR
authors.lastname: Li
authors.affiliation: Department of General Surgery, Institute of General Surgery, Jinling Hospital, Nanjing, Jiangsu 210002, China.
authors.forename: Jie-Shou
authors.initials: JS
authors.lastname: Li
mesh_terms: D000074323:Alemtuzumab; D000818:Animals; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D017209:Apoptosis / Q000187:drug effects; D005434:Flow Cytometry; D007422:Intestines / Q000166:cytology*; D008214:Lymphocytes / Q000187:drug effects*; D008252:Macaca fascicularis; D008297:Male; D046529:Microscopy, Electron, Transmission
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D000074323:Alemtuzumab