Efficacy and safety of infliximab in the treatment of severe plaque psoriasis and its effect on the expression of programmed cell death-1 and programmed cell death ligand-1 / 中华皮肤科杂志

Objective:To investigate the efficacy and safety of infliximab in the treatment of severe plaque psoriasis and its effect on the expression of programmed cell death-1 (PD-1) and programmed cell death ligand-1 (PD-L1) in psoriatic lesions.Methods:A total of 17 patients with severe plaque psoriasis were enrolled from Shanghai Skin Disease Hospital from February 2019 to April 2019, and were treated with intravenous drips of infliximab at a dose of 5 mg/kg at weeks 0, 2, 6, 14, 22, 30, 38 and 46. Efficacy was evaluated by using the psoriasis area and severity index (PASI) score at weeks 2, 6, 10, 14, 22, 30, 38, 46 and 52, and adverse events were recorded during the trial. Real-time PCR was performed to determine the expression of PD-1 and PD-L1 in skin tissues of 8 volunteer controls, as well as in skin lesions of 14 patients with plaque psoriasis before treatment and 5 patients with plaque psoriasis after 10-week treatment, and immunofluorescence assay to measure the expression of PD-1 and PD-L1 in skin tissues of 5 volunteers and 5 patients with psoriasis. The independent sample t-test was used to compare the expression of PD-1 and PD-L1 in skin tissues between the patients with plaque psoriasis and controls, and paired t-test to compare the expression of PD-1 and PD-L1 in the skin lesions of patients before and after infliximab treatment. Results:After 2, 6, 10, 14, 22, 30, 38, 46 and 52 weeks of infliximab treatment, the proportion of patients with plaque psoriasis achieving PASI75 was 1/17, 6/16, 9/16, 10/16, 15/15, 14/15, 13/14, 11/13 and 10/11, respectively. Antinuclear antibody staining turned positive in 12 patients, which was the most common adverse reaction, and 1 patient experienced an infusion reaction, which was the most severe adverse reaction. Before the treatment, the expression of PD-1 and PD-L1 (1.111 ± 0.391, 0.902 ± 0.169, respectively) was significantly higher in the skin lesions of patients with psoriasis than in the skin tissues of controls (0.620 ± 0.225, t=3.116, P=0.007; 0.474 ± 0.360, t=3.208, P=0.006, respectively) ; after infliximab treatment, the expression of PD-1 and PD-L1 (0.570 ± 0.230, 0.150 ± 0.050, respectively) in the improved skin lesions was significantly lower than that in the corresponding lesions before the treatment (1.238 ± 0.414, t=3.107, P=0.036; 0.966 ± 0.184, t=8.423, P=0.001, respectively) . Conclusions:Infliximab is effective and safe for the treatment of plaque psoriasis, but monitoring is necessary during treatment. The expression of PD-1 and PD-L1 is aberrantly upregulated in plaque psoriasis lesions, and decreased after infliximab treatment, suggesting that PD-1/PD-L1 may be involved in inflammation regulation in psoriasis.

Expression of inhibitory receptors on CD4+ and CD8+ T cells from healthy Colombian donors / Expresión de receptores Inhibidores en linfocitos T CD4+ y CD8+ de donantes sanos Colombianos / Expressão de receptores inibitórios sobre linfócitos T CD4+ e CD8+ de doadores saudáveis Colombianos

T cell activation involves positive cellular signals that promote effector functions and negative signals that contribute to the regulation of these responses. These regulatory signals are generated upon activation of receptors on T cells that include CD160, 2B4, Programmed Death-1 and CTLA-4. Objective. To evaluate the expression of inhibitory receptors like CD160, 2B4, Programmed Death-1 and CTLA-4 on CD4+ and CD8+ T cells from healthy Colombian donors. Materials and methods. Peripheral blood mononuclear cells from 30 healthy donors from Bogotá (Colombia) were obtained via Ficoll-Hypaque density gradient and cells were stained with specific conjugated antibodies previously titrated. Results. The CD160, 2B4, and Programmed Death-1 inhibitory markers were detected on CD4+ T cells with expression levels of 0.35%, 1.04%, and 1.35%, respectively. On CD8+ T cells, these markers were expressed at higher levels: 16%, 8.97%, and 4.3%, respectively. In contrast to the other receptors, CTLA-4 frequency of expression showed no significant difference between CD4+ (1.56%) and CD8+ (1.53%) T cells. Frequency of CD160/2B4 and CTLA-4/ Programmed Death-1 coexpression was 0.18% and 0.09% on CD4+ cells, and 4.02% and 0.2% on CD8+ T cells. Conclusions. This is the first report showing the frequency of inhibitory receptors such as CD160, 2B4, Programmed Death-1, and CTLA-4 on CD4+ and CD8+ T cells from healthy Colombian donors. Our findings serve as a baseline for the analysis and comparison of these receptors in Colombian populations with different disease conditions.

La activación de células T involucra señales positivas que promueven funciones efectoras y señales negativas que contribuyen a la regulación de la respuesta inmune. Estas actividades regulatorias son generadas por la activación de receptores de las células T e incluyen moléculas como CD160, 2B4, PD-1 y CTLA-4. Objetivo. Evaluar la expresión de los receptores inhibitorios CD160, 2B4, PD-1 y CTLA-4 en células T CD4+ y CD8+ de donantes sanos colombianos. Materiales y métodos. Se obtuvieron células mononucleares de sangre periférica de 30 donantes sanos provenientes de Bogotá (Colombia) mediante gradiente de densidad por Ficoll-Hypaque, las células fueron marcadas con anticuerpos conjugados a fluorocromos previamente titulados. Resultados. CD160, 2B4, y PD-1 presentaron porcentajes de expresión en células T CD4+ de 0.35%, 1.04% y 1.35% respectivamente. En células T CD8+ estos receptores mostraron niveles de expresión más altos con porcentajes de 16.3%, 8.97% y 4.3% respectivamente. A diferencia de los otros receptores, CTLA-4 no mostró diferencias entre células T CD4+ (1.56%) y CD8+ (1.53%). Los porcentajes de co-expresión de CD160/2B4 y CTLA-4/PD-1 en células T CD4+ fueron de 0.18% y 0.09%, en células T CD8+ se observaron porcentajes de expresión de 4.02% y 0.2%. Conclusión. Este es el primer reporte que muestra la frecuencia de expresión de receptores inhibitorios tales como CD160, 2B4, PD-1 y CTLA-4 en células T CD4+ y CD8+ de donantes sanos colombianos. Estos hallazgos representan una línea de base para el análisis y la comparación de estos receptores en la población colombiana con diferentes enfermedades.

A ativação de células T envolve sinais positivos que promovem funções efetoras e sinais negativos que contribuem para a regulação da resposta imune. Estas atividades reguladoras são geradas através da ativação de receptores de células T e incluem moléculas tais como CD160, 2B4, PD-1 e CTLA-4. Objetivo. Avaliar a expressão de receptores inibitórios CD160 e 2B4, PD-1 e CTLA-4 em células T CD4+ e CD8+ de doadores saudáveis colombianos. Materiais e métodos. Foram obtidas células mononucleares do sangue periférico de 30 doadores saudáveis provenientes de Bogotá (Colômbia) a partir de gradiente de densidade por Ficoll-Hypaque, as células foram marcadas com anticorpos conjugados com fluorocromos previamente titulados. Resultados. CD160, 2B4, e PD-1 mostraram percentagens de expressão em células T CD4+ de 0,35%, 1,04% e 1,35%, respectivamente. Em células T CD8+ estes receptores mostraram níveis de expressão mais elevados com percentagens de 16,3%, 8,97% e 4,3% respectivamente. Ao contrário de outros receptores, CTLA-4 não apresentou diferenças entre células T CD4+ (1,56%) e CD8+ (1,53%). As percentagens de co-expressão de CD160/2B4 e CTLA-4/PD-1 em células T CD4+ foram de 0,18% e 0,09%; em células T CD8+ foram observadas percentagens de expressão de 4,02% e 0,2%. Conclusão. Este é o primeiro relatório que apresenta a frequência de expressão de receptores inibitórios tais como CD160, 2B4, PD-1 e CTLA-4 em células T CD4+ e CD8+ de doadores saudáveis colombianos. Estes resultados representam uma linha de base para análise e comparação desses receptores na população colombiana com diferentes doenças.

Advances in the expression of killer cell inhibitory receptors by T cells / 中国病理生理杂志

Only in recent years, attentions have been drawn to the significance of expressing killer cell inhibitory receptors (KIR) in T cells KIRs specifically bind to the corresponding region of the MHC class I molecules and transmit negative signals to prevent cytotoxity of T cells. When the ligands of KIRs are missing, the lysis of the target cells can't be avoided. Perhaps the existence of KIRs is the main mechanism for preventing T cells from attacking autologous tissues. The recognition mechanism of the interaction between the KIR + donor T cells and the recipient's MHC class I molecule expressing tissue cells might shed light on the establishment of the immunotolerance for the prevention of allo-graft rejection and graft-versus-host disease.