Endometriosis Patients Show an Increased M2 Response in the Peritoneal CD14(+low)/CD68(+low)Macrophage Subpopulation Coupled with an Increase in the T-helper 2 and T-regulatory Cells
REPRODUCTIVE SCIENCES
Authors: Hudson, Quanah J.; Ashjaei, Kazem; Perricos, Alexandra; Kuessel, Lorenz; Husslein, Heinrich; Wenzl, Rene; Yotova, Iveta
Abstract
Endometriosis is a chronic inflammatory disease associated with an impaired immune response at the site of lesion implantation. The ability of macrophages to respond to changes in their environment is critical for an effective immune response. However, the existing knowledge of the peritoneal immune cell populations, their activation state and contribution to the immunological changes that occur in endometriosis are still controversial and inconclusive. In this study, we have examined the relative abundance of peritoneal macrophage subtypes, in women with (n = 21) versus without (n = 18) endometriosis and disease-associated changes in the adaptive T cell response. Using flow cytometry, we showed that peritoneal fluid monocyte/macrophages are composed of two populations of cells that exhibit major differences in the levels of the CD14 and CD68 markers, which we classified as the CD14(+low)/CD68(+low)and CD14(+high)/CD68(+high)subpopulations. Moreover, endometriosis-associated changes in the macrophage subtypes occurred only in the CD14(+low)/CD68(+low)subpopulation. In this subpopulation, we found an increased macrophage type 2 response that was coupled with an increase in peritoneal T-helper 2 and T-regulatory cell populations in women with endometriosis, compared with controls. In summary, this study resolves conflicting data in the literature regarding changes in the peritoneal immune cell population in endometriosis and identifies CD14(+low)/CD68(+low)macrophages as the subpopulation that changes in response to the disease.
Reduced Toxicity Conditioning for Nonmalignant Hematopoietic Cell Transplants
BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION
Authors: Contreras, Cristina F.; Long-Boyle, Janel R.; Shimano, Kristin A.; Melton, Alexis; Kharbanda, Sandhya; Dara, Jasmeen; Higham, Christine; Huang, James N.; Cowan, Morton J.; Dvorak, Christopher C.
Abstract
Allogeneic hematopoietic cell transplantation (HCT) for children with nonmalignant disorders is challenged by potential drug-related toxicities and poor engraftment. This retrospective analysis expands on our single pediatric medical center experience with targeted busulfan, fludarabine, and intravenous (IV) alemtuzumab as a low-toxicity regimen to achieve sustained donor engraftment. Sixty-two patients received this regimen for their first HCT for a nonmalignant disorder between 2004 and 2018. Donors were matched sibling in 27%, 8/8 HLA allele-matched unrelated in 50%, and 7/8 HLA allele-mismatched in 23% (some of whom received additional immunoablation with thiotepa or clofarabine). Five patients experienced graft failure for a cumulative incidence of 8.4% (95% CI, 1 to 16%). In engrafted patients, the median donor chimerism in whole blood and CD3, CD14/15, and CD19 subsets at 1-year were 96%, 90%, 99%, and 99%, respectively. Only one patient received donor lymphocyte infusions (DLIs) for poor chimerism. Two patients died following disease progression despite 100% donor chimerism. The 3-year cumulative incidence of treatment-related mortality was 10% (95% CI, 2 to 17%). Overall survival and event-free-survival at 3-years were 87% (95% CI, 78 to 95%) and 80% (95% CI, 70 to 90%), respectively. The 6-month cumulative incidence of grade II to IV acute graft-versus-host disease (GVHD) was 7% (95% CI, 3 to 13%), while the 3-year cumulative incidence of chronic GVHD was 5% (95% CI, 0 to 11%). These results suggest that use of targeted busulfan, fludarabine and IV alemtuzumab offers a well-tolerated option for children with nonmalignant disorders to achieve sustained engraftment with a low incidence of GVHD. (C) 2020 American Society for Transplantation and Cellular Therapy. Published by Elsevier Inc.