Soluble interleukin 2 receptor and soluble CD8 levels in previously treated human immunodeficiency virus-negative hemophiliacs multiply transfused with a monoclonal antibody-purified factor VIII concentrate

• Published in: Transfusion (Philadelphia, Pa.) Pa.), 1997-01, Vol.37 (1), p.86-89
• Main Authors: Smid, W.M., Martens, A., van der Meer, J., Hegge-Paping, C.S.M., Halie, M.R.
• Format: Article
• Language: English
• Subjects: Adult; AIDS/HIV; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Antibodies, Monoclonal - administration & dosage; Biological and medical sciences; Blood Transfusion; Blood. Blood and plasma substitutes. Blood products. Blood cells. Blood typing. Plasmapheresis. Apheresis; CD8 Antigens - blood; Factor VIII - administration & dosage; Factor VIII - immunology; Fundamental and applied biological sciences. Psychology; Hemophilia A - blood; Hemophilia A - immunology; Hemophilia A - therapy; HIV Seronegativity - physiology; HLA-DR Antigens - analysis; Humans; Lymphocyte Count; Medical sciences; Middle Aged; Receptors, Interleukin-2 - blood; Solubility; T-Lymphocytes - cytology; T-Lymphocytes - immunology; Transfusions. Complications. Transfusion reactions. Cell and gene therapy; Vertebrates: blood, hematopoietic organs, reticuloendothelial system
• ISSN: 0041-1132; 1537-2995
• DOI: 10.1046/j.1537-2995.1997.37197176956.x

BACKGROUND: Serum levels of the soluble interleukin 2 receptor (sIL‐2R) and soluble CD8 (sCD8) may be used as markers of T‐cell activation. The course of serum levels of sIL‐2R and sCD8 in hemophiliacs who were treated first with an intermediate‐purity factor VIII concentrate and then with a monoclonal antibody (MoAb)‐purified factor VIII concentrate are reported. STUDY DESIGN AND METHODS: Serum samples taken before the administration of the MoAb‐purified concentrate and after 2 and 5 years of its administration to 20 human immunodeficiency virus‐negative patients with hemophilia A were analyzed. Eighteen healthy age‐matched men were used as controls. RESULTS: The sIL‐2R and sCD8 levels were higher in patients treated with intermediate‐purity concentrates than in controls (p = 0.006 and p = 0.0005, respectively). The sIL‐2R levels showed a decrease after 5 years of treatment with the MoAb‐purified concentrate (p = 0.018 for the difference between 2 and 5 years), to levels that were not significantly different from those in controls. Although sCD8 levels tended to decrease at 5 years (p = 0.09, for the difference between 2 and 5 years), they remained higher than those in controls (p = 0.0005 and p = 0.0016 at 2 and 5 years, respectively). The ratio of sCD8 and sIL‐2R tended to increase between 2 and 5 years (p = 0.07). The sIL‐2R and sCD8 levels were not related to the numbers of T‐lymphocytes and HLA‐DR‐positive T‐lymphocytes in peripheral blood. Nor was a relation demonstrated between sIL‐2R levels and CD4‐positive cell numbers or between sCD8 levels and CD8‐positive cell numbers. Although a relation with chronic hepatitis C cannot be excluded, it seems more likely that changes in sIL‐2R levels are due to the use of the MoAb‐purified concentrate. CONCLUSION: Elevated levels of sIL‐2R and sCD8 were found in multiply transfused human immunodeficiency virus‐ negative hemophiliacs. After treatment was changed to the use of a MoAb‐ purified concentrate. sIL‐2R levels decreased. These findings suggest a change in immune stimulation that is remarkable, because signs of activation in the effector phase seem to have continued despite normalization in the proliferative phase.