Department of Rheumatology and Immunology, Faculty of Medicine, Albert Szent-Györgyi Health Center, University of Szeged, Kálvária sgt. 57, Szeged, 6725, Hungary.
First Department of Obstetrics and Gynecology, Semmelweis University, Budapest, Hungary.
Arch Immunol Ther Exp (Warsz). 2020 Apr 4;68(2):12. doi: 10.1007/s00005-020-00575-5.
The effect of TNF-blockers on T-lymphocyte subsets is largely unknown in inflammatory bowel diseases (IBDs). The aim of the present study was to analyze the prevalence of T-cell subtypes and their correlation to therapeutic response. Sixty-eight patients with Crohn's disease (CD), 46 with ulcerative colitis (UC) were enrolled. (1) The clinical course was followed after the initiation of TNF-blockers (prospective study). (2) The immunophenotype was also compared between long-term anti-TNF treated-responders and non-responders (cross-sectional study). The results were compared with those of therapy-naïve patients with active disease and those in remission with non-biological immunosuppressive therapy, and with healthy controls. Fourteen subtypes of peripheral blood T cells were measured with flow cytometry. The prevalence of Th2 and Th17 cells, of HLA-DR- and CD69-positive CD4 and CD8 cells, was higher, whereas the percentage of CD45RA-positive CD4 and CD8 cells was lower in both IBDs than in controls. CD8CD69 cell frequency was lower in remission, and decreased during anti-TNF therapy in CD responders. CD8CD45RO memory cells had higher prevalence in UC non-responders than in those starting anti-TNF. CD4CD45RO percentage < 49.05 at the initiation of TNF-blockers was predictive of a subsequent therapeutic response in CD, and Th2 and Th17 prevalence correlated with the duration of remission on TNF-blockers in UC. This study provided a detailed description of the T-cell composition in IBDs. CD8CD69 prevalence may be an activity marker in CD, and CD4CD45RO, Th2 and Th17 levels could be predictive for a therapeutic response to anti-TNF.
TNF 阻滞剂对炎症性肠病（IBD）中 T 淋巴细胞亚群的影响尚不清楚。本研究旨在分析 T 细胞亚群的患病率及其与治疗反应的相关性。共纳入 68 例克罗恩病（CD）患者和 46 例溃疡性结肠炎（UC）患者。（1）在开始使用 TNF 阻滞剂后（前瞻性研究）随访临床病程。（2）还比较了长期接受抗 TNF 治疗的应答者和无应答者之间的免疫表型（横断面研究）。将结果与处于活动期的初治患者、接受非生物免疫抑制治疗缓解的患者和健康对照者进行比较。用流式细胞术测量了外周血 T 细胞的 14 种亚型。CD4 和 CD8 细胞中 Th2 和 Th17 细胞、HLA-DR 和 CD69 阳性细胞的比例较高，而 CD4 和 CD8 细胞中 CD45RA 阳性细胞的比例在两种 IBD 中均低于对照组。缓解期 CD8CD69 细胞频率较低，CD 应答者在接受抗 TNF 治疗期间该频率降低。与开始使用抗 TNF 治疗的患者相比，UC 无应答者的 CD8CD45RO 记忆细胞比例更高。在开始使用 TNF 阻滞剂时 CD4CD45RO 百分比<49.05 可预测 CD 患者随后的治疗反应，而 UC 中 Th2 和 Th17 患病率与 TNF 阻滞剂缓解时间相关。本研究详细描述了 IBD 中的 T 细胞组成。CD8CD69 的患病率可能是 CD 中的活动标志物，而 CD4CD45RO、Th2 和 Th17 水平可能可预测抗 TNF 治疗的反应。
