Abnormal numbers of CD4+ T lymphocytes and abnormal expression of CD4+ T lymphocyte-secreted cytokines in patients with immune-related haemocytopenia

In the past decade, a group of cases with persisting haemocytopenia were separated from those with idiopathic cytopenia of undetermined significance due to the optimal response of these patients to immunosuppression therapy and due to the detection of autoantibodies in the bone marrow of haemopoietic cells. This condition was termed immune-related haemocytopenia (IRH). However, the quantity of T lymphocytes remained unknown. In the present study, the percentage of CD4(+) T-cell subsets and related cytokines was measured using flow cytometry and an enzyme-linked immunosorbent assay. An abnormal number of CD4(+) T cell subsets was found, including increased percentages of T helper (Th)2, Th9 and Th17 cells and a decreased number of regulatory T (Treg) cells. In addition, the results showed downregulation in the levels of interleukin (IL)-2, transforming growth factor-beta and IL-35, and upregulation in the levels of IL-4, IL-6, IL-17, IL-23 and interferon-gamma in patients who did not receive therapy (untreated patients). These levels were significantly associated with the number of peripheral blood cells and were recovered following treatment. In conclusion, an abnormal number of CD4(+) T cell subsets and corresponding abnormal levels of regulatory cytokines resulted in the stimulation of B1 lymphocytes to produce autoantibodies in IRH, which may be considered as markers to evaluate disease prognosis and treatment strategies.