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In vitro production of anti‐RBC antibodies and cytokines in chronic lymphocytic leukemia
Author(s) -
Barcellini W.,
Montesano R.,
Clerici G.,
Zanii A.,
Imperiali F.G.,
Calori R.,
Cortelezzi A.,
Zanella A.
Publication year - 2002
Publication title -
american journal of hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.456
H-Index - 105
eISSN - 1096-8652
pISSN - 0361-8609
DOI - 10.1002/ajh.10210
Subject(s) - autoimmunity , autoantibody , chronic lymphocytic leukemia , immunology , autoimmune hemolytic anemia , medicine , cytokine , antibody , leukemia
B‐chronic lymphocytic leukemia (B‐CLL) patients have a high prevalence of autoimmune phenomena, mainly autoimmune hemolytic anemia (AIHA). Immunoregulatory cytokines play a role in the regulation of both autoimmunity and leukemic B‐cell growth. Mitogen‐stimulated direct antiglobulin test (MS‐DAT) is a recently described test able to disclose latent anti‐RBC autoimmunity in AIHA. We investigated the prevalence of anti‐RBC autoimmunity by MS‐DAT and the pattern of cytokine production by PHA‐stimulated whole blood cultures from 69 B‐CLL patients and 53 controls. Results showed that anti‐RBC IgG values in unstimulated, PHA‐, PMA‐, and PWM‐stimulated cultures were significantly higher in B‐CLL patients compared with controls. In B‐CLL, the prevalence of anti‐RBC autoimmunity was 28.9% by MS‐DAT, compared with 4.3% by the standard DAT. Production of IFN‐γ, IL‐2, IL‐13, TNF‐α, sCD23, and sCD30 was significantly increased in all B‐CLL patients compared with controls, whereas there was no difference in IL‐4, IL‐6, IL‐10, and TGF‐β production. Multivariate analysis showed that IL‐4 was significantly increased in MS‐DAT‐positive compared with ‐negative patients. Patients with autoantibody positivity displayed greater IFN‐γ production than negative patients. These data are in line with the hypothesis that autoimmune phenomena in B‐CLL are associated with an imbalance towards a Th‐2‐like profile. The elevated prevalence of anti‐RBC autoimmunity found by MS‐DAT suggests that an underestimated latent autoimmunity exists in B‐CLL. Am. J. Hematol. 71:177–183, 2002. © 2002 Wiley‐Liss, Inc.