1. T-cell dynamics after high-dose chemotherapy in adults: elucidation of the elusive CD8+ subset reveals multiple homeostatic T-cell compartments with distinct implications for immune competence
- Author
-
N. Gibelli, Rosanna Vescovini, Gioacchino Robustelli della Cuna, Barbara Oliviero, C. Zibera, Paolo Sansoni, Lorenzo Pavesi, Alberto Zambelli, L. Ponchio, Laura Lozza, Gianantonio Da Prada, R. Gennari, and Francesco Fagnoni
- Subjects
Adult ,CD4-Positive T-Lymphocytes ,medicine.medical_treatment ,T cell ,Immunology ,CD4-CD8 Ratio ,chemical and pharmacologic phenomena ,Breast Neoplasms ,Cell Separation ,Biology ,CD8-Positive T-Lymphocytes ,Immune system ,CD28 Antigens ,In vivo ,T-Lymphocyte Subsets ,Antineoplastic Combined Chemotherapy Protocols ,medicine ,Immune Tolerance ,Immunology and Allergy ,Homeostasis ,Humans ,Aged ,Chemotherapy ,Hematopoietic Stem Cell Transplantation ,CD28 ,hemic and immune systems ,Original Articles ,Middle Aged ,Fas receptor ,Flow Cytometry ,Cell biology ,medicine.anatomical_structure ,Female ,CD8 ,Cell Division ,Follow-Up Studies - Abstract
Recovery of total T cell numbers after in vivo T-cell depletion in humans is accompanied by complex perturbation within the CD8+ subset. We aimed to elucidate the reconstitution of CD8+ T cells by separate analysis of putative naive CD95− CD28+, memory CD95+ CD28+ and CD28− T cell compartments after acute maximal depletion by high-dose chemotherapy (HD-ChT) in women with high-risk breast cancer. We found that recovery of putative naive CD8+ CD95− CD28+ and CD4+ CD95− CD28+ T cells, was compatible with a thymus-dependent regenerative pathway since their recovery was slow and time-dependent, their values were tightly related to each other, and their reconstitution patterns were inversely related to age. By analysing non-naive T cells, a striking diversion between putative memory T cells and CD28− T cells was found. These latter increased early well beyond normal values, thus playing a pivotal role in total T-cell homeostasis, and contributed to reduce the CD4 : CD8 ratio. In contrast, putative memory T cells returned to values not significantly different from those seen in patients at diagnosis, indicating that this compartment may recover after HD-ChT. At 3–5 years after treatment, naive T cells persisted at low levels, with expansion of CD28− T cells, suggesting that such alterations may extend further. These findings indicate that CD28− T cells were responsible for ‘blind’ T-cell homeostasis, but support the notion that memory and naive T cells are regulated separately. Given their distinct dynamics, quantitative evaluation of T-cell pools in patients undergoing chemotherapy should take into account separate analysis of naive, memory and CD28− T cells.
- Published
- 2002