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- Title
CD4+ T cell counts reflect the immunosuppressive state of CD4 helper cells in patients after allogeneic stem cell transplantation.
- Authors
Holtick, Udo; Frenzel, Lukas; Shimabukuro-Vornhagen, Alexander; Theurich, Sebastian; Claasen, Julia; Scheid, Christof; Bergwelt-Baildon, Michael; Fröhlich, Holger; Wendtner, Clemens; Chemnitz, Jens
- Abstract
The recovery of the host immune system after allogeneic hematopoietic stem cell transplantation is pivotal to prevent infections, relapse, and secondary malignancies. In particular, numerical CD4+ T cells reconstitution is delayed and CD4 helper cell function is considered impaired as a consequence of the transplant procedure and concomitant immunosuppressive medication. From HIV/AIDS patients, it is known that numerical and functional CD4 defects increase the risk of opportunistic infections. However, and in contrast to patients with HIV, anti-infective prophylaxis after allogeneic transplantation is usually given for 6 months depending on immunosuppressive medication and existing graft-versus-host disease but independently of absolute CD4+ T cells counts. We hypothesized that a qualitative T cell defect is existing after allogeneic transplantation, especially in patients with delayed immune-reconstitution. Applying transcriptional as well as functional approaches, we show that CD4+ T cells with delayed recovery have a distinct transcriptional profile and cluster differently from T cells originated from patients with completed immune recovery. Moreover, inhibitory signatures are substantially enriched within the transcriptional profile of these T cells translating to functional defects and impaired interleukin 2 production. In addition to time after transplant, CD4+ T cells numbers should be considered for the decision to stop or maintain antimicrobial prophylaxis in patients after allogeneic stem cell transplantation.
- Subjects
CD4 antigen; T cells; IMMUNOSUPPRESSIVE agents; STEM cell transplantation; GRAFT versus host disease; IMMUNE reconstitution inflammatory syndrome
- Publication
Annals of Hematology, 2015, Vol 94, Issue 1, p129
- ISSN
0939-5555
- Publication type
Article
- DOI
10.1007/s00277-014-2166-1