Maintenance of cytomegalovirus-specific CD4posT-cell response in rheumatoid arthritis patients receiving anti-tumor necrosis factor treatments

Abstract

Introduction: Anti-tumor necrosis factor (TNF)-α biotherapies have considerably changed the treatment of rheumatoid arthritis (RA). However, serious infections are a major concern in patients with rheumatic diseases treated with anti-TNF-α. Little is known about viral, especially latent, infections in anti-TNF-α treatments. Infections by cytomegalovirus (CMV), a β-herpes virus, are frequent and induce a strong CD4posT-cell immunity, which participates in the control of infection. We thus have chosen to analyze the CD4posT-cell response to CMV antigens as a model of antiviral response in RA patients treated with anti-TNF-α. CD28 expression was evaluated.Methods: We have measured the CD4posresponse to CMV antigens in RA patients, before and after initiation of treatment with an anti-TNF-α agent. The intracellular production of interferon (IFN)-γ in total and CD28negCD4posT cells in response to CMV antigens (Ags) was evaluated with flow cytometry. The proliferation of total CD4posT cells in the presence of CMV antigens was measured with 3H-thymidine incorporation.Results: Anti-TNF-α treatments impaired neither the anti-CD4posanti-CMV IFN-γ response nor the proliferative response in patients. The percentage of CD28negCD4poscells remained constant.Conclusions: Our data suggest that the CD4posT-cell response against CMV is not altered by anti-TNF-α treatments and that infection remains controlled in treated RA patients latently infected with CMV. Our observation brings new insight into the current knowledge of the risks of infection in patients treated with anti-TNF-α biotherapies. © 2010 Davignon et al.; licensee BioMed Central Ltd.