PMID- 33545400
OWN - NLM
STAT- MEDLINE
DCOM- 20210708
LR  - 20210708
IS  - 2213-2201 (Electronic)
VI  - 9
IP  - 6
DP  - 2021 Jun
TI  - CD3(-)CD4(+) Lymphocytic Variant Hypereosinophilic Syndrome: Diagnostic Tools 
      Revisited.
PG  - 2426-2439.e7
LID - S2213-2198(21)00158-6 [pii]
LID - 10.1016/j.jaip.2021.01.030 [doi]
AB  - BACKGROUND: Identification of patients with lymphocytic variant hypereosinophilic 
      syndrome (L-HES) is challenging, and has important prognostic and therapeutic 
      implications. OBJECTIVE: This study was undertaken to assess diagnostic tools for 
      L-HES and to develop evidence-based diagnostic recommendations. METHODS: 
      Biomarkers of T-cell-driven disease were compared between patients with L-HES 
      versus idiopathic HES (I-HES) variants. Those performed routinely (serum 
      immunoglobulin levels, T-cell phenotyping, T-cell receptor [TCR] gene 
      rearrangement patterns) were collected from medical files, whereas others were 
      prospectively assessed on stored blood samples (serum CCL17/thymus and activation 
      regulated chemokine [TARC] levels, in vitro cytokine production). RESULTS: This 
      study included 48 patients with I-HES and 20 with L-HES associated with a 
      CD3(-)CD4(+) T-cell subset, including 7 with less than 5% aberrant cells. Neither 
      increased serum immunoglobulin levels nor clonal TCR gene rearrangements were 
      sufficiently sensitive or specific for L-HES. In contrast, systematically 
      enhanced expression of the T-cell surface antigens CD2, CD5, CD45RO, and CD95 by 
      these cells allowed for accurate detection by flow cytometry. Serum CCL17/TARC 
      levels were significantly higher in patients with L-HES compared with those with 
      I-HES, and a threshold of 3000 pg/mL allowed for detection of all subjects with 
      L-HES with 75% specificity. Quantification of intracytoplasmic cytokine 
      production by flow cytometry is the most reliable method for detection of 
      enhanced type 2 cytokine expression, most notably for IL-4 and IL-13. CONCLUSION: 
      Adapting the standard of procedure for T-cell phenotyping in patients with 
      unexplained hypereosinophilia is currently the most reliable means of identifying 
      those with CD3(-)CD4(+) L-HES.
CI  - Copyright (c) 2021 American Academy of Allergy, Asthma & Immunology. Published by 
      Elsevier Inc. All rights reserved.
FAU - Carpentier, Caroline
AU  - Carpentier C
AD  - Department of Internal Medicine, Hopital Erasme, Universite Libre de Bruxelles, 
      Brussels, Belgium.
FAU - Schandene, Liliane
AU  - Schandene L
AD  - Laboratory of Immunology, Hopital Erasme, Universite Libre de Bruxelles, 
      Brussels, Belgium.
FAU - Dewispelaere, Laurent
AU  - Dewispelaere L
AD  - Department of Medical Genetics, Hopital Erasme, Universite Libre de Bruxelles, 
      Brussels, Belgium.
FAU - Heimann, Pierre
AU  - Heimann P
AD  - Department of Medical Genetics, Hopital Erasme, Universite Libre de Bruxelles, 
      Brussels, Belgium.
FAU - Cogan, Elie
AU  - Cogan E
AD  - Department of Internal Medicine, Hopital Erasme, Universite Libre de Bruxelles, 
      Brussels, Belgium.
FAU - Roufosse, Florence
AU  - Roufosse F
AD  - Department of Internal Medicine, Hopital Erasme, Universite Libre de Bruxelles, 
      Brussels, Belgium; Institute for Medical Immunology, Universite Libre de 
      Bruxelles, Gosselies, Belgium. Electronic address: froufoss@ulb.ac.be.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20210203
PL  - United States
TA  - J Allergy Clin Immunol Pract
JT  - The journal of allergy and clinical immunology. In practice
JID - 101597220
RN  - 0 (CD3 Complex)
RN  - 0 (Cytokines)
SB  - IM
MH  - CD3 Complex
MH  - CD4-Positive T-Lymphocytes
MH  - Cytokines
MH  - Humans
MH  - *Hypereosinophilic Syndrome/diagnosis/genetics
MH  - T-Lymphocytes
OTO - NOTNLM
OT  - CCL17/TARC
OT  - CD3(-)CD4(+) T cells
OT  - Hypereosinophilic syndrome
OT  - IL-5
OT  - Intracytoplasmic cytokines
OT  - Lymphocytic variant
OT  - T-cell phenotyping
OT  - TCR gene rearrangement
EDAT- 2021/02/06 06:00
MHDA- 2021/07/09 06:00
CRDT- 2021/02/05 20:11
PHST- 2020/10/07 00:00 [received]
PHST- 2021/01/13 00:00 [revised]
PHST- 2021/01/16 00:00 [accepted]
PHST- 2021/02/06 06:00 [pubmed]
PHST- 2021/07/09 06:00 [medline]
PHST- 2021/02/05 20:11 [entrez]
AID - S2213-2198(21)00158-6 [pii]
AID - 10.1016/j.jaip.2021.01.030 [doi]
PST - ppublish
SO  - J Allergy Clin Immunol Pract. 2021 Jun;9(6):2426-2439.e7. doi: 
      10.1016/j.jaip.2021.01.030. Epub 2021 Feb 3.