Dynamics of T cell subpopulation in patients with aplastic anemia during immunosuppressive therapy

Autor: A. V. Abramova, E. A. Mikhailova, I. V. Galtseva, Z. T. Fidarova, A. V. Luchkin, N. M. Kapranov, Yu. O. Davydova, S. M. Kulikov, V. V. Troitskaya, E. N. Parovichnikova
Jazyk: ruština
Rok vydání: 2024
Předmět:
Zdroj: Онкогематология, Vol 19, Iss 3, Pp 159-172 (2024)
Druh dokumentu: article
ISSN: 1818-8346
2413-4023
DOI: 10.17650/1818-8346-2024-19-3-159-172
Popis: Background. Aplastic anemia (AA) is a non-tumor and rare disease of the blood system, characterized by deep pancytopenia due to the development of bone marrow aplasia with immune-mediated damage of hematopoietic stem cells. Research results indicate the presence of antigenic effects leading to pathological activation and dysregulation of the T cells in the bone marrow with increased production of pro-inflammatory cytokines that damage hematopoietic stem cells. The triggering factor that initiates the cascade of immune reactions is currently unknown. The high efficiency of immunosuppressive therapy (IST), which allows achieving remission in the majority of AA patients, is evidence of the immune genesis of the disease. The pathogenesis of AA is currently being actively studied. The participation of T cell subpopulations in immune response is beyond doubt, but the issues of their significance in the AA pathogenesis have not been fully studied. A more detailed understanding of the AA development mechanisms is necessary for the development of long-term effective treatment.Aim. To investigate the T cells subpopulation in bone marrow of AA patients during IST.Materials and methods. The study included 41 patients over 18 years of age with newly diagnosed acquired AA without previous IST. Treatment was carried out according to a protocol including horse antithymocyte globulin and cyclosporine. Flow cytometry was used to detect T cell subpopulations. Bone marrow examination was performed at three time points: initially, 3 and 6 months after initiation of combined IST.Results. Multidirectional changes in the T cell subpopulations ratio before the start of IST were found in all AA patients included in the prospective study: most patients had a higher proportion of effector CD4+ and CD8+ T cells (61 and 83 % of patients, respectively), memory CD4+ T cells (63 % of patients), and a lower proportion of naive CD4+ and CD8+ T cells (81 and 51 % of patients, respectively) compared to donors (p
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