ABSTRACT
INTRODUCTION: This study aimed to assess the correlation between the percentage of CD14(+) HLA-DR(low/-) immunosuppressive monocytes, plasma arginase 1 level, and disease aggressiveness in patients with B-cell non-Hodgkin lymphoma. METHODS: Forty-two patients with B-cell non-Hodgkin lymphoma and 20 healthy volunteers were enrolled in this study. Peripheral blood CD14+ HLA-DR(low/-) monocytes were detected by Flow cytometry, and their correlation with disease relapse and refractoriness was analyzed. RESULTS: The percent of CD14(+) HLA-DR(low/-) monocytes was significantly higher in the lymphoma patients than in the healthy controls (control, 9.3 ± 4%; lymphoma, 35.8 ± 20.2%; P < 0.0001), higher in stage III& IV than stage II (stage II, 26.48 ± 17%, n = 26; stage III & IV, 50.8 ± 15.4%, n = 16; P < 0.0001), more in diffuse large cell lymphoma than other pathology types and in relapsed/refractory patients than in patients who achieved remission during follow-up (relapsed/refractory, n = 18, 45.7 ± 16.7%; remission, n = 16, 21.4 ± 16.2%; P < 0.0001). The arginase I level correlated with increased percent of CD14(+) HLA-DR(low/-) monocytes (P < 0.0001). CONCLUSION: Increased CD14(+) monocytes with loss of HLA expression were seen in patients with higher stage disease, more aggressive pathology, and in relapse or refractoriness to treatment. Identifying therapeutic strategies to overcome the suppressive properties of these monocytes could be of value.
Subject(s)
B-Lymphocytes/pathology , HLA-DR Antigens/genetics , Lipopolysaccharide Receptors/genetics , Lymphoma, Non-Hodgkin/pathology , Monocytes/metabolism , Adult , Aged , Antineoplastic Agents/therapeutic use , Arginase/blood , Arginase/genetics , B-Lymphocytes/metabolism , Case-Control Studies , Female , Flow Cytometry , Gene Expression , HLA-DR Antigens/blood , Humans , Immunophenotyping , Lipopolysaccharide Receptors/blood , Lymphoma, Non-Hodgkin/blood , Lymphoma, Non-Hodgkin/drug therapy , Lymphoma, Non-Hodgkin/genetics , Male , Middle Aged , Monocytes/pathology , Neoplasm Staging , Prognosis , RecurrenceABSTRACT
OBJECTIVE: Assess the value of baseline interferon-γ-inducible protein-10 (IP-10) levels as a noninvasive maker of liver fibrosis and as a predictor of response to interferon therapy in HCV genotype 4 infected patients. METHODS: Eighty-four HCV genotype 4 infected patients were enrolled in this study. Degrees of liver fibrosis were determined and baseline IP-10 was measured in serum samples collected prior to initiation of treatment using the enzyme-linked immunosorbent assay. Patients were followed up for 1.5 year to assess their response to antiviral therapy. RESULTS: The baseline IP-10 levels were significantly correlated with the degree of fibrosis and had the ability to differentiate between patients with mild, moderate and advanced stages of fibrosis (F0-1: 95.24 ± 33.08 pg/ml, n = 25; F2: 158.70 ± 52.74 pg/ml, n = 37; F3-4: 357.45 ± 162.18 pg/ml, n = 22; P <0.001). Baseline IP-10 levels were significantly lower in patients achieved Early virological response (responders 134.80 ± 60.47 pg/ml, n = 60; non-responders 334.54 ± 168.94 pg/ml, n = 24, P <0.001). Also baseline IP-10 levels were significantly lower in patients who became HCV RNA negative at 24 weeks of therapy (179.52 ± 130.03 pg/ml, n = 78) than non-responders (352.33 ± 132.58 pg/ml, n = 6, P = 0.002). SVR was achieved in 58/68 (85.3%) patients while 10 patients were relapsed. Baseline IP-10 levels differs significantly between patients who achieved SVR at week 24 post therapy and relapsed patients (IP10 level: SVR, 173.52 ± 125.20 pg/ml, n = 58; Relapsed, 216.20 ± 67.72 pg/ml, n = 10, P = 0.021). CONCLUSION: Baseline IP-10 level independently predicts EVR, response at week 24 during therapy and SVR. It also differentiates patients with mild fibrosis from those with moderate and advanced fibrosis.
