Effects of infliximab on peripheral lymphocyte subsets of patients with active inflammatory bowel disease / 中华消化杂志

ABSTRACT

Objective To investigate the change of the distribution of peripheral blood lymphocyte subsets,before and after treated by infliximab (IFX) in patients with inflammatory bowel disease (IBD).Methods From September 2008 to January 2013,a total of 20 patients with IBD accepted more than three times of IFX treatment and on time follow-up were collected,11 cases of ulcerative colitis (UC) and nine of Crohn's disease (CD).At same time,20 healthy individuals were enrolled as healthy control group.The efficacy of IFX on patients with UC or CD was evaluated according to Mayo score and simplified Crohn's disease active index (CDAI) before and after treatment.Fasting blood of healthy control group,one day before IFX treatment and in 24 to 72 hours after the third time of IFX injection of IBD patients was collected.The percentage of total T lymphocyte,total B lymphocyte,CD4+ T lymphocyte,CD8+ T lymphocyte and natural killer (NK) cell in lymphocyte was determined by fluorescent labeled monoclonal antibodies and flow cytometry.Independent sample t-test was performed for comparison between two groups.Analysis of variance was for comparison among three groups.Results Three of 11 patients with UC achieved clinical remission,three cases were clinical improved and five cases were ineffectiveness.Among nine CD patients,one achieved clinical remission,six cases were clinical improved and two cases were ineffectiveness.Of UC patients,the percentage of total T lymphocyte before and after treatment ((84.2±8.1) ％ and (82.1±6.2)％),the percentage of CD8+ T lymphocyte before treatment ((40.0± 13.2)％) were all higher than that of healthy control group ((74.7±10.7)％ and (30.5±11.9) ％),while the percentage of NK cell before and after treatment ((5.1±2.8)％ and (7.8±4.3)％) were all lower than that of healthy control group ((13.7 ±7.8)％) and the differences were statistically significant (t=2.540,2.074,2.251,3.464 and 2.063,all P＜0.05).Compared with healthy controls,there were no significant differences in the percentage of total B lymphocyte and CD4+ T lymphocyte of UC patients before and after treatment,the percentage of total T lymphocyte,total B lymphocyte,CD4+ T lymphocyte,CD8+T lymphocyte and NK cell of CD patients before and after treatment (all P＞0.05).Before treatment,there were significant differences among effective treatment group,ineffective treatment group and healthy control group in the percentage of total T lymphocyte,CD8+ T lymphocyte and NK cell (F=4.095,4.571 and 7.432,all P＜0.05),of those there were significant differences between ineffective treatment group ((88.3 ± 8.2) ％,(44.4 ± 11.5) ％ and (4.6 ± 3.2) ％) and healthy control group (t=2.902,2.105 and 3.647,all P＜0.05).Conclusion The percentage of peripheral blood total T lymphocyte and CD8+T lymphocyte increase in active IBD patients with ineffective IFX treatment,however the percentage of NK cell decreases.