Cyclophosphamide Treatment Modulates Circulating Cell Populations in Patients with Vasculitis and Autoimmune Systemic Diseases

Martina Skácelová¹, Gabriela Gabčová², Pavel Horak³, Zuzana Mikulková², František Mrázek⁴, Eva Kriegová⁵ and Andrea Smržová⁶, ¹III. Department of Internal Medicine, Faculty of Medicine and Dentistry, Palacký University of Olomouc, Olomouc, Czech Republic, ²Department of Immunology, Faculty of Medicine and Dentistry, Palacky University Olomouc, Olomouc, Czech Republic, ³III. Department of internal medicine, III. Department of Internal Medicine, Faculty of Medicine and Dentistry, Palacký University of Olomouc, Olomouc, Czech Republic, ⁴Department of Immunology, Faculty of Medicine and Dentistry, Palacky University of Olomouc, Olomouc, Czech Republic, ⁵Department of Immunology, Department of Immunology, Faculty of Medicine and Dentistry, Palacky University of Olomouc, Olomouc, Czech Republic, ⁶III. Department of Internal Medicine, III. Department of Internal Medicine, Faculty of Medicine and Dentistry, Palacký University of Olomouc, Olomouc, Czech Republic

Meeting: 2017 ACR/ARHP Annual Meeting

Date of first publication: September 18, 2017

Keywords: autoimmune diseases, B cells, Cyclophosphamide and vasculitis, T cells

Session Information

Date: Tuesday, November 7, 2017

Title: Vasculitis Poster III: Other Vasculitis Syndromes

Session Type: ACR Poster Session C

Session Time: 9:00AM-11:00AM

Background/Purpose: Although cyclophosphamide (CFA) remain the cornerstone for treatment of patients with severe manifestations of systemic autoimmune diseases, the knowledge about the effect of CFA on circulating cell populations in these diseases is limited.

Objectives: To investigate the effect of CFA administration on circulating immune cell subpopulations in patients with vasculitis and autoimmune systemic diseases.

Methods: We analysed major immune cell populations in peripheral blood (PB) from 13 patients (vasculitis n=7; autoimmune systemic diseases n=6). Paired samples from each patient were analysed before CFA administration, and after one and six months’ follow-up. Using 6-colour flow cytometer (BD FACSCanto II) we characterized T lymphocytes (CD3, CD4, CD8, CD25, CD127, HLA-DR), B lymphocytes (CD19, CD20, CD27, HLA-DR), NK cells (CD3, CD16, CD56, CD69), neutrophils (CD15, CD11b, CD16, CD54, CD62L, CD64), and monocytes (CD11b, CD14, CD16, CD64, HLA-DR). Statistics was done by software GraphPad Prism.

Results: After single dose of CFA, the percentage of CD69+ NK cells increased and CD4+/CD8+ ratio decreased compared with their percentage before administration (P=0.01; P=0.03, respectively). After six months of CFA administration, decreased percentage of activation marker HLA-DR on CD4+ cells (P=0.004), decreased percentage of CD19+ B cells (P=0.04) and increased percentage of activation marker CD69 on NK cells (P=0.004) was observed comparing with paired samples obtained before CFA therapy. Different patterns were observed in subgroups of patients with vasculitis and autoimmune systemic diseases. Clinical evaluation of treatment response and observed changes in immune cell populations in individual patients is ongoing.

Conclusion: In our patients, CFA therapy resulted in changes of activation markers on CD4+, CD8+, B and NK cells, as well as neutrophils. Further investigation of selected markers may lead to identification of new biomarkers for prediction of the treatment effectiveness.

Acknowledgement: MZ CR VES15-28659A, IGA_LF_2017_009

Disclosure: M. Skácelová, None; G. Gabčová, None; P. Horak, None; Z. Mikulková, None; F. Mrázek, None; E. Kriegová, None; A. Smržová, None.

To cite this abstract in AMA style:

Skácelová M, Gabčová G, Horak P, Mikulková Z, Mrázek F, Kriegová E, Smržová A. Cyclophosphamide Treatment Modulates Circulating Cell Populations in Patients with Vasculitis and Autoimmune Systemic Diseases [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/cyclophosphamide-treatment-modulates-circulating-cell-populations-in-patients-with-vasculitis-and-autoimmune-systemic-diseases/. Accessed .

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