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J Garcia-Suarez, A Prieto, E Reyes, L Manzano, JL Merino and M Alvarez-Mon
Departamento de Medicina, Hospital Universitario Principe de Asturias,
Universidad de Alcala de Henares, Madrid, Spain.
Recent studies have indicated that autoimmune thrombocytopenic purpura
(ATP) patients show immune system alterations that are not restricted to
the B-cell compartment, but that also affect T lymphocytes. This report
studies the phenotypic characteristics of natural killer (NK) cells in the
peripheral blood of ATP patients, as well as their clinical significance in
33 ATP patients with active disease. Ten patients had stable disease
(sustained platelet counts > 50,000/microL without the need for
treatment), whereas 23 patients had therapy- dependent disease (platelet
counts < 50,000/microL). A significant increase in both CD56+ CD3- NK
cells and CD56+ CD3+ cytotoxic T lymphocytes was observed in peripheral
blood mononuclear cells and in purified CD2+ cells from therapy-dependent
ATP patients as compared with ATP patients with stable disease and healthy
controls. Moreover, there were more major histocompatibility complex (MHC)
class II molecules in the CD56+ CD3- cells from the therapy-dependent
patients' peripheral blood preparations than there were in the stable ATP
patients' and healthy controls' peripheral blood preparations. This growth
in the number of CD56+ CD3- NK cells was statistically higher in patients
whose disease was refractory to conventional therapy (corticosteroids and
splenectomy). In addition to the CD56+ CD3- NK cells, the percentage of
CD3+ T lymphocytes and their proliferative response to phytohemagglutinin
(PHA) stimulation were studied in fresh CD2+ preparations from nine
patients with stable disease, 22 patients with therapy-dependent disease,
and 26 healthy controls. The proliferative response of CD2+ lymphocytes
from both groups was similar and significantly defective with respect to
that found in healthy controls. In conclusion, clinically severe ATP
(therapy-dependent disease) is associated with a significant increase of
CD56+ CD3- NK cells, which is particularly marked in patients whose disease
is refractory to therapy.
This article has been cited by other articles:
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| Copyright © 1993 by American Society of Hematology Online ISSN: 1528-0020 | |||||||||
