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David Valent, Robert B Nussenblatt, H Nida Sen; CD4+ and CD8+ T Lymphocyte Levels in Uveitis Patients Treated with Cellcept. Invest. Ophthalmol. Vis. Sci. 2016;57(12):1898.
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© ARVO (1962-2015); The Authors (2016-present)
Cellcept (Mycophenolate Mofetil) is an immunosuppressive agent that inhibits the purine synthesis pathway and has been used as a steroid-sparing agent in non-infectious uveitis. Cellcept suppresses lymphocyte proliferation, but little has been published on its effects on CD4+ and CD8+ lymphocyte levels. This study examined the levels of CD4+ and CD8+ T Lymphocytes in patient with non-infectious uveitis treated with Cellcept.
This single-center, case-control series, enrolled 54 patients (mean age 44.5 years) taking Cellcept, of various dosages and durations, for the treatment of non-infectious uveitis. Levels of CD4+ and CD8+ T lymphocytes were acquired using peripheral blood. Lymphocytes levels were also evaluated in 55 patients with various uveitidites (mean age: 49.9 years), who were not currently being treated with Cellcept, which served as the control group. Of these 55 control participants, 45 (81.8%) were not on any immunomodulatory agents when CD4+ and CD8+ levels were evaluated.
The average duration of Cellcept treatment in the study group was 33.3 months (range: 0.25-104 months). Based on SUN criteria, anterior, intermediate, posterior and panuveitis were diagnosed in 7.4%, 11.1%, 44.4%, and 37.0% in the study group respectively, and 18.2%, 14.5%, 32.7%, and 34.5% in the control group. The average CD4+ and CD8+ levels were 870.9 cells/µL (range: 186-2632 cells/µL) and 411.3 cells/µL (range: 40-1434 cells/µL) in the study group and 966.2 cells/µL (range: 265-2593 cells/µL) and 450.6 cells/µL (range: 73-1658 cells/µL) in the control group, respectively. There were a total of 7 (12.9%) patients in the study group (average CD4+: 260.8 cells/ µL) and 3 (5.4%) in the control group (average CD4+: 289 cells/µL) with low CD4 levels. (p = 0.20) Five patients (9.3%) in the study group and 3 patients (5.5%) in the control group had low CD8+ levels. Two participants (3.6%) in the control group not on any immunomodulatory therapy had an abnormal CD4+ T lymphocyte level. One participant in the control group with abnormal CD4+ T lymphocyte level, had a history of cellcept use.
There was a higher percentage of patients with reduced CD4+ T Lymphocyte levels among those treated with Cellcept compared with uveitis patients on a regimen excluding Cellcept. Prospective studies should be considered to further investigate the effect of Cellcept on CD4+ lymphocyte levels.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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