Immune phenotype in children with therapy-na&iuml;ve remitted and relapsed Crohn&rsquo;s disease

doi:10.3748/wjg.v16.i47.6001

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World Journal of Gastroenterology

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1007-9327

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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World J Gastroenterol. Dec 21, 2010; 16(47): 6001-6009
Published online Dec 21, 2010. doi: 10.3748/wjg.v16.i47.6001

Table 1 Clinical data and patient characteristics

	Control	Therapy-naïve (before conventional therapy)	First remission (with conventional therapy)	Relapse (before IFX therapy)	IFX therapy (before 2nd infusion)	IFX therapy (before 3rd infusion)
Clinical data
n (boys/girls)	15 (6/9)	14 (6/8)	10 (4/6)	12 (5/7)
Age (yr)	12 (8-16)	10 (8.5-13)	11.5 (9.5-15.5)	14 (11-16)	14.5 (11.5-16)	14.5 (12-16)
Body mass index (kg/m²)	19.5 (16.5-22.3)	13.9 (12.5-15.8)^d	18.6 (14.4-19.2)^c	17.4 (14.1-19.5)^a	18.8 (14.6-21.3)	19.25 (16.1-22.1)
Body weight (percentile)	58 (35-79)	13 (4-23)^d	24 (19-44)^c	21 (7-28)^a	23 (15-63)	35 (10-74)
Disease duration (mo)	-	10 (8.5-13)	10.5 (8.5-15.5)	11.5 (9.25-15)	12 (9.5-15)	12 (10-15)
Activity index (PCDAI)	-	45 (39-58)	0 (0-5)^f	45 (25-48)^j	20 (7-28)^g	13 (2-22)^l
Localization (n, montreal criteria)	-	L1 (1), L2 (2), L3 (11)	L1 (0), L2 (2), L3 (8)	L1 (1), L2 (2), L3 (9)
Laboratory data
White blood cell count (g/L)	7.9 (5.7-10.1)	12.4 (9.4-14.2)^b	11.7 (8.4-14.4)	10 (8.2-11.2)	7.9 (5.5-10.6)	6.7 (4.5-10.4)^e
Platelet (g/L)	346 (288-375)	657 (451-746)^b	442 (308-624)	479 (396-750)^b	392 (293-523)	383 (308-483)^e
Serum iron (μmol/L)	16 (14-21)	4 (2-12)^a	8 (4-10)^a	4 (2-7)^d	5 (4-7)^d	8 (6-8)^b^e
Serum albumin (g/L)	45 (44-49)	37 (34-39)^d	42 (42-45)^c	40 (36-41)^d	41 (38-45)^b	42 (38-45)^b
C-reactive protein (mg/L)	0 (0-1)	21 (5-65)^d	7 (2-11)^b^c	27 (9-55)^h, ^d	9 (3-11)^d	5 (1-14)^d^e

^aP < 0.05,

^bP < 0.01;

^dP < 0.01 vs control;

^cP < 0.05,

^fP < 0.01 vs therapy-naïve;

^hP < 0.01,

^jP < 0.01 vs first remission;

^eP < 0.05,

^gP < 0.05,

^lP < 0.001 vs relapse. IFX: Infliximab; PCDAI: Pediatric Crohn's disease activity index; L1: Small bowel; L2: Large bowel; L3: Small bowel and large bowel localization according to Montreal criteria[48].

Table 2 Prevalence and ratios of cellular members of adaptive immunity

Cell prevalence in parent population	Control	Therapy-naïve (before conventional therapy)	First remission (with conventional therapy)	Relapse (before IFX therapy)	IFX therapy (before 2nd infusion)	IFX therapy (before 3rd infusion)
CD4⁺ in PBMC	35.16 (24.81-47.79)	36.52 (18.61-44.06)	37.42 (22.27-44.26)	39.12 (24.15-51.18)	39.77 (27.71-50.30)	35.65 (24.31-48.81)
Activated in CD4⁺	5.92 (2.39-6.51)	10.61 (3.93-19.04)^a	5.03 (3.37-7.93)^g	7.84 (5.30-11.67)^a	7.24 (5.67-12.25)^a	9.98 (5.45-16.19)^b
Naïve in CD4⁺	64.57 (59.86-73.03)	63.36 (41.19-74.86)	61.31 (39.09-73.05)	66.31 (60.44-71.79)	64.47 (53.90-77.87)	58.11 (53.51-64.96)
Effector in CD4⁺	21.91 (13.94-33.96)	31.29 (22.80-55.78)^a	33.97 (28.54-39.44)^a	29.47 (26.54-36.19)^a	35.23 (27.74-40.36)^a	37.62 (35.74-45.24)^bⁱ
Naïve/effector ratio	2.73 (1.60-4.97)	1.57 (1.02-2.54)^a	1.43 (1.14-2.21)^a	2.34 (1.66-2.68)	1.79 (1.47-2.36)	1.52 (1.19-1.74)^a^e
Th1 in CD4⁺	16.19 (9.91-25.26)	6.49 (4.50-7.67)^d	12.89 (5.12-19.03)^c	10.9 (4.03-14.38)^a	12.73 (8.12-15.81)	18.87 (12.51-38.11)^e
Th2 in CD4⁺	4.59 (2.78-5.51)	4.7 (1.98-6.03)	5.06 (1.42-8.48)	3.97 (2.27-7.19)	4.61 (2.55-5.65)	4.46 (2.11-8.16)
Th1/Th2 ratio	3.98 (3.06-5.12)	1.60 (0.50-2.11)^d	1.95 (0.43-3.62)^b	2.68 (0.85-5.07)	2.68 (1.42-6.14)	3.25 (1.37-4.80)^e
Treg in CD4⁺	1.25 (1.10-2.37)	1.36 (1.09-2.48)	1.41 (1.07-3.50)	1.31 (1.16-2.63)	1.33 (1.07-2.99)	1.96 (1.47-3.77)^b^e

^aP < 0.05,

^bP < 0.01,

^dP < 0.01 vs control;

^cP < 0.05,

^gP < 0.01 vs therapy-naïve;

^eP < 0.05,

ⁱP < 0.01 vs relapse. Data are expressed as median (interquartile range). IFX: Infliximab; PBMC: Peripheral blood mononuclear cell; Activated (CD25⁺); Naïve (CD45RA⁺); Effector (CD45RO⁺); Th1: T helper 1 committed, CXCR3⁺; Th2: T helper 2 committed, CCR4⁺; Treg: Regulatory T lymphocytes, CD25^hiFoxP3⁺.

Table 3 Prevalence and ratios of cellular members of innate immunity

Cell prevalence in parent population	Control	Therapy-naïve (before conventional therapy)	First remission (with conventional therapy)	Relapse (before IFX therapy)	IFX therapy (before 2nd infusion)	IFX therapy (before 3rd infusion)
NKT in PBMC	1.39 (0.81-2.42)	0.7 (0.11-1.33)^a	0.74 (0.37-1.34)	0.72 (0.45-1.23)	0.73 (0.37-1.20)	0.83 (0.31-2.05)
NK in PBMC	3.17 (1.71-4.76)	1.73 (0.72-3.49)^a	1.98 (1.65-2.97)	1.95 (0.72-4.81)	2.14 (0.66-4.78)	2.45 (1.26-4.85)
DC in PBMC	0.61 (0.10-2.15)	1.05 (0.54-3.32)^a	1.16 (0.58-2.98)^a	1.45 (1.09-3.46)^a	0.86 (0.30-2.80)	0.82 (0.52-2.31)
mDC in DC	46.04 (37.14-52.30)	61.66 (45.37-72.74)^b	45.19 (37.83-56.68)^c	69.01 (40.11-74.79)^a^e	60.01 (48.03-68.50)^a	57.39 (37.19-64.14)^a^g
pDC in DC	27.38 (20.65-33.94)	19.26 (15.08-24.58)^a	21.61 (14.76-32.61)^a	18.33 (16.59-26.42)^a	19.03 (17.26-32.38)	27.39 (19.68-36.70)^g
mDC/pDC ratio	1.85 (0.44-1.46)	3.05 (2.32-6.11)^d	2.35 (1.80-9.10)^b^c	3.5 (1.74-7.79)^d	3.04 (2.03-4.65)^d	2.20 (1.66-5.54)^b^g
TLR-2 in DC	8.8 (4.14-17.35)	55.08 (37.27-57.94)^d	17.32 (6.32-32.54)^c	38.7 (19.31-54.59)^b^e	25.89 (5.69-60.43)	16.70 (2.29-42.61)^g
TLR-4 in DC	2.24 (0.90-2.78)	14.36 (6.26-19.20)^b	2.73 (1.35-7.21)^f	10.11 (2.29-19.55)^a^e	5.31 (2.81-13.42)	3.32 (0.10-6.05)^g
Monocyte in PBMC	2.01 (1.38-3.82)	8.57 (3.82-16.72)^b	5.96 (2.49-21.22)^a^c	7.3 (2.65-15.44)^a	5.58 (2.78-17.52)^a	5.31 (3.54-6.94)^a
TLR-2 in monocyte	16.44 (10.31-19.69)	29.65 (17.83-39.77)^a	20.92 (7.87-29.15)^c	20.63 (7.05-29.01)	19.89 (13.13-29.32)	18.52 (10.29-28.96)
TLR-4 in monocyte	7.17 (0.45-14.73)	14.59 (3.01-35.23)^a	4.43 (1.82-8.31)^c	10.39 (2.10-26.54)	8.26 (2.71-17.56)	6.30 (2.48-18.94)

^aP < 0.05,

^bP < 0.01,

^dP < 0.001 vs control;

^cP < 0.05,

^fP < 0.01 vs therapy-naïve;

^eP < 0.05 vs first remission;

^gP < 0.05 vs relapse. Data are expressed as median (interquartile range). IFX: Infliximab; PBMC: Peripheral blood mononuclear cell; NK: Natural killer, CD3^-CD161⁺; NKT: Natural killer T, CD3⁺6b11⁺; DC: Dendritic cell, Lin1-HLA-DR⁺; mDC: Myeloid dendritic cell, CD11c⁺; pDC: Plasmocytoid dendritic cell, CD123⁺; Monocyte (CD14⁺); TLR: Toll-like receptor.

Citation: Cseh A, Vasarhelyi B, Molnar K, Szalay B, Svec P, Treszl A, Dezsofi A, Lakatos PL, Arato A, Tulassay T, Veres G. Immune phenotype in children with therapy-naïve remitted and relapsed Crohn’s disease. World J Gastroenterol 2010; 16(47): 6001-6009
URL: https://www.wjgnet.com/1007-9327/full/v16/i47/6001.htm
DOI: https://dx.doi.org/10.3748/wjg.v16.i47.6001