The effect of immunotherapy with self activated T lymphocytes on the population composition of B cells and the expression of CD23 on them in patients with various phenotypes of bronchial asthma

Makarova A.E., Blinova E.A., Pashkina E.A., Nepomnyashchikh V.M., Leonova M.I., Demina D.V., Kozlov V.A.

Research Institute of fundamental and cliniclal immunology, Novosibirsk, Russia
Novosibirsk state medical University of the Ministry of Health of the Russian Federation, Novosibirsk, Russia

Objective. To evaluate the quantitative characteristics of B-lymphocyte populations, B-reg cells, B-cells that express the low-affinity IgE receptor (CD23) in patients with different phenotypes of BA during combined therapy with autologous activated T-cells, in patients continuing only standard therapy, and in donors.
Methods. The pilot non-randomized study included 43 persons, including 30 patients diagnosed with bronchial asthma, average age 39±4.3 years, and 13 donors defined as conditionally healthy, average age 28±7.03 years. 16 persons with allergic bronchial asthma and 7 persons with non-allergic bronchial asthma were receiving combined therapy. Autologous T-lymphocytes were activated by Roncoleukin and anti-CD3 antibodies in vitro and administered to patients subcutaneously. The therapy was carried out in 2 stages: initiating (weekly – 4 injections) and maintaining stage (monthly – 6 injections), a total of 10 injections over 7 months. Treatment was administered alongside standard combination therapy. A separate group of patients with allergic bronchial asthma (7 persons) continued standard therapy throughout the observation period.
Results. It was found that the allergic and non-allergic forms of bronchial asthma did not differ significantly in the content of B1 (CD19+CD5+), B2 (CD19+CD5-) lymphocyte subpopulations. The relative number of B1- (p=0.024) and B2- (p=0.046) cells carrying the CD23 receptor decreased significantly 7 months after the start of treatment in patients with the allergic phenotype of BA who received treatment with T-lymphocytes and simultaneously continued therapy in accordance with the stepwise approach. In the group of patients who continued only stepwise therapy, there was no significant change in the number of B-cells expressing CD23. In patients with non-allergic bronchial asthma, the relative number of B-cell subpopulations and the number of B-lymphocytes carrying the CD23 receptor did not show significant differences from the indicators of donors considered conditionally healthy, as well as no changes in the studied parameters in the dynamics of combination immunotherapy. A significant increase in the quantitative characteristic of CD19+CD5+Foxp3+ B-regulatory cells was observed during combination therapy after 7 months in patients with non-allergic bronchial asthma.
Conclusion. The use of therapy based on introduction of autologous activated T-lymphocytes alongside standard treatment in patients with allergic bronchial asthma contributed to a decrease in the number of B-cells expressing the low-affinity IgE receptor, which reflects the effect of combination immunotherapy on the pathogenetic mechanisms of allergic bronchial asthma.