Analysis of regulatory T-cell changes in patients with idiopathic thrombocytopenic purpura receiving B cell depleting therapy with rituximab

  • Stasi R
  • Cooper N
  • Poeta G
 et al. 
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The effects of B-cell depletion with ritux-imab on regulatory T cells (Tregs) have not been determined. We investigated Tregs in patients receiving rituximab for chronic idiopathic thrombocytopenic purpura (ITP). The peripheral blood Tregs, identified as CD4+FOXP3+ T cells, were measured by flow cytometry prior to and after the immunotherapy. In addition, Tregs were analyzed for their usage of the T-cell receptor (TCR) p-variable (VB) region gene as well as their regulatory function as assessed by cell proliferation assays. Pretreatment data revealed a reduced number and a defective suppressive capacity of Tregs in ITP patients compared with control individuals. In addition, Tregs showed a polyclonal spectra-type. Patients, particularly responders, showed restored numbers of Tregs as well as a restored regulatory function upon treatment with rituximab. These results indicate that patients with active ITP have a defective T regulatory cell compartment that can be modulated by a B cell-targeted therapy. (copyright) 2008 by The American Society of Hematology.

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  • Roberto Stasi

  • Nichola Cooper

  • Giovanni Del Poeta

  • Elisa Stipa

  • Maria Laura Evangelista

  • Elisabetta Abruzzese

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