LONG-TERM IMMUNOMODULATORY EFFECTS OF LYMPHOCYTE-T DEPLETION IN PATIENTS WITH SYSTEMIC-SCLEROSIS
LONG-TERM IMMUNOMODULATORY EFFECTS OF LYMPHOCYTE-T DEPLETION IN PATIENTS WITH SYSTEMIC-SCLEROSIS
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DOI：
10.1002/art.1780330408
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发表时间：
1990-04-01
影响因子：
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通讯作者：
WEYAND, CM
中科院分区：
文献类型：
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作者：
GORONZY, JJ;WEYAND, CM
我们描述了 2 名患有快速进展的系统性硬化症的患者，对常规治疗没有反应，他们接受了 5 天的 T 细胞特异性抗淋巴细胞球蛋白治疗。一名患者的肺部受累情况恶化，另一名患者出现了伴有多发性溃疡和坏疽的致残性皮肤病。两名患者的病情均有所改善，CD4+ 和 CD8+ T 淋巴细胞几乎完全消除。外周 T 细胞的再生需要 60-90 天，随后 CD4:CD8 比率长期反转。两名患者的持续治疗效果与 CD4+ T 细胞的缺乏和 CD8+ T 细胞的优势相关。这表明 T 细胞免疫在系统性硬化症的发病机制中发挥着至关重要的作用。再生 T 细胞的体外研究表明 CD4+ 辅助/诱导细胞具有功能能力。 CD8+ 群体组成的变化可以解释在治疗获益期间观察到的 CD4+ T 细胞的长期抑制。
We describe 2 patients with rapidly progressing systemic sclerosis that did not respond to conventional therapy, who were treated with a 5-day regimen of T cell-specific antilymphocyte globulin. One patient had deteriorating pulmonary involvement, and the second patient had developed disabling skin disease with multiple ulcers and gangrene. Both patients showed improvement concomitant with almost complete elimination of CD4+ and CD8+ T lymphocytes. Regeneration of peripheral T cells required 60-90 days and was followed by a long-term inversion of the CD4:CD8 ratio. The persistent therapeutic effect in both patients correlated with the lack of CD4+ T cells and the predominance of CD8+ T cells. This suggests a crucial role of T cell immunity in the pathogenesis of systemic sclerosis. In vitro studies of regenerating T cells demonstrated that CD4+ helper/inducer cells were functionally competent. Alterations in the composition of the CD8+ population may explain the prolonged suppression of CD4+ T cells observed during the period of therapeutic benefit.