The immunologic abnormalities in patients with paroxysmal nocturnal hemoglobinuria are associated with disease progression

Saudi Med J. 2024 Apr;45(4):424-432. doi: 10.15537/smj.2024.45.4.20231010.

Abstract

Objectives: To suggest the presence of a hyperimmune state in patients, and indicate that immune system attack on glycosylphosphatidylinositol (+) (GPI+) cells while escaping GPI- cell immunity.

Methods: We retrospective the immune cell subtypes in peripheral blood from 25 patients visiting Tianjin Medical University General Hospital, Tianjin, China, with classical paroxysmal nocturnal hemoglobinuria (PNH) and 50 healthy controls.

Results: The total CD3+ and CD3+CD8+ cell levels were higher in patients with PNH. The CD3+ cells are positively, correlated with lactate dehydrogenase (LDH; r=0.5453, p=0.0040), indirect bilirubin (r=0.4260, p=0.0379) and Flear- cells in monocytes (r=0.4099, p=0.0303). However, a negative correlation was observed between CD3+ cells and hemoglobin (r= -0.4530, p=0.0105). The total CD19+ cells decreased in patients, and CD19+ cells were negatively correlated with LDH (r= -0.5640, p=0.0077) and Flear- cells in monocytes (r= -0.4432, p=0.0341). Patients showed an increased proportion of total dendritic cells (DCs), with a higher proportion of myeloid DCs (mDCs) within the DC population. Moreover, the proportion of mDC/DC was positively correlated with CD59- cells (II + III types) in red cells (r=0.7941, p=0.0004), Flear- cells in granulocytes (r=0.5357, p=0.0396), and monocytes (r=0.6445, p=0.0095).

Conclusion: Our results demonstrated that immune abnormalities are associated with PNH development.

Keywords: B-cells; T-cells; cytokines; dendritic cells; paroxysmal nocturnal hemoglobinuria.

MeSH terms

  • Adult
  • Antigens, CD19
  • CD3 Complex / metabolism
  • Case-Control Studies
  • Dendritic Cells / immunology
  • Disease Progression*
  • Female
  • Glycosylphosphatidylinositols / immunology
  • Hemoglobinuria, Paroxysmal* / blood
  • Hemoglobinuria, Paroxysmal* / immunology
  • Humans
  • L-Lactate Dehydrogenase / blood
  • Male
  • Middle Aged
  • Monocytes / immunology
  • Retrospective Studies
  • Young Adult

Substances

  • L-Lactate Dehydrogenase
  • CD3 Complex
  • Glycosylphosphatidylinositols
  • Antigens, CD19