Lymphocyte homeostasis following therapeutic lymphocyte depletion in multiple sclerosis.

Journal article

Following lymphocyte depletion, homeostatic mechanisms drive the reconstitution of lymphocytes. We prospectively studied this process in 16 patients for 1 year after a single pulse of treatment with Campath-1H, a humanised anti-CD52 monoclonal antibody. We observed two phases of lymphocyte reconstitution. In the first 6 months after treatment the precursor frequency and proliferation index of the patients' autologous mixed lymphocyte reaction increased; the depleted T cell pool was dominated by memory T cells, especially (CD4+)CD25high T cells, a putative regulatory phenotype; and there was a non-significant rise in peripheral mononuclear cell FoxP3 mRNA expression and fall in constitutive cytokine mRNA expression. In the later phase, from 6-to-12 months after Campath-1H, these changes reversed and there was a rise in ROG mRNA expression. However, total CD4+ numbers remained below 50% of pre-treatment levels at 12 months, perhaps reflecting a failure in homeostasis. This was not due to an impaired IL-7 response, as in rheumatoid arthritis, nor to a lack of IL-7 receptors, which are found on fewer human (CD4+)CD25high than naive cells. We speculate that CCL21 and IL-15 responses to lymphopaenia may be suboptimal in multiple sclerosis.

Authors: Cox, A; Thompson, SA; Jones, J; Robertson, V; Hale, G

• Publication status: Published
• Journal: European journal of immunology
• Volume: 35
• Issue: 11
• Pages: 3332-3342
• Publication date: 2005-11-01
• DOI: 10.1002/eji.200535075
• EISSN: 1521-4141
• ISSN: 0014-2980
• Language: English
• Keywords: Th1 Cells; Antibodies, Monoclonal; Prospective Studies; Multiple Sclerosis; Female; Chemokines, CC; Middle Aged; Gene Expression Regulation; Homeostasis; Cell Proliferation; Interleukin-15; CD4-Positive T-Lymphocytes; Adult; Receptors, Interleukin-7; Immunologic Memory; Interleukin-7; Antibodies, Neoplasm; Receptors, Interleukin-2; Lymphocyte Depletion; Chemokine CCL21; Cells, Cultured; Humans; Male; Th2 Cells; Antibodies, Monoclonal, Humanized