Modulatory Effect of the Euro-Lupus Low-Dose Intravenous Cyclophosphamide Regimen on Circulating Immune Cells in Systemic Lupus Erythematosus
Language English Country Poland Media print-electronic
Document type Journal Article
Grant support
FNOL
Ministerstvo Zdravotnictví České Republiky
00098892
Ministerstvo Zdravotnictví České Republiky
IGA_LF_2019_006
Univerzita Palackého v Olomouci
IGA_LF_2019_014
Univerzita Palackého v Olomouci
PubMed
31620814
DOI
10.1007/s00005-019-00563-4
PII: 10.1007/s00005-019-00563-4
Knihovny.cz E-resources
- Keywords
- Cyclophosphamide, Flow cytometry, Immunophenotyping, Lupus nephritis, SLE, Treatment outcome,
- MeSH
- Cyclophosphamide therapeutic use MeSH
- Adult MeSH
- Immunologic Memory MeSH
- Immunomodulation MeSH
- Immunosuppressive Agents therapeutic use MeSH
- Remission Induction MeSH
- Administration, Intravenous MeSH
- Clinical Protocols MeSH
- Cohort Studies MeSH
- Blood Circulation MeSH
- Middle Aged MeSH
- Humans MeSH
- Lymphocytes drug effects immunology MeSH
- Young Adult MeSH
- Lupus Nephritis drug therapy MeSH
- Flow Cytometry MeSH
- Lupus Erythematosus, Systemic drug therapy MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Young Adult MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Names of Substances
- Cyclophosphamide MeSH
- Immunosuppressive Agents MeSH
A Euro-Lupus regimen of low-dose intravenous cyclophosphamide (CFA) is commonly used to treat severe organ manifestations of systemic lupus erythematosus (SLE), particularly lupus nephritis (LN). There are no data on the distributions and dynamics of immune cell populations in patients with various treatment outcomes. The circulating immune cells of 11 female SLE patients were assessed before and after Euro-Lupus regimen (cumulative dose of 3000 mg CFA) by flow cytometry together with those of 16 healthy women. A subanalysis was performed in LN patients who achieved complete remission (CR; n = 3), partial remission (PR; n = 4), and no response (NR; n = 2). In SLE, the Euro-Lupus regimen decreased the percentage and absolute count of B cells; increased the percentage of CD8+ T cells, T regulatory cells, neutrophils, and monocyte subsets; and activated T and NK cells compared to healthy controls (P < 0.050). Patients with LN achieving CR had significantly lower proportions of CD27+ B memory cells compared to poor responders (PR/NR, P = 0.035). The post-treatment percentages and absolute numbers of B cells, T cells, NK cells, monocytes, and neutrophils showed high inter-individual variability with no association with treatment outcome. Our pilot study revealed the dynamics of changes in immune cell populations in SLE patients during a Euro-Lupus regimen, mainly the lowering of B cells. In LN patients who achieved CR, a lower proportion of CD27+ B memory cells was evident compared to poor responders (PR/NR). Further studies on usefulness of monitoring immune cells for treatment response prediction on larger cohorts are needed.
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