Functional and phenotypical alterations of polymorphonuclear cells in Sézary syndrome patients

Maria Teresa Fierro1, Anna Maria Cuffini, Mauro Novelli

  • 1Department of Dermatology, Biomedical Sciences and Human Oncology, Turin University, Via Cherasco 23, 10126 Turin, Italy.

Insights

Sézary syndrome patients show impaired polymorphonucleate granulocyte (PMN) function, leading to increased infection risk. This study highlights reduced PMN phagocytosis and killing activity in Sézary syndrome, correlating with recurrent infections.

Area of Science:

  • Immunology
  • Hematology
  • Dermatology

Background:

  • Sézary syndrome (SS), a leukemic form of cutaneous T-cell lymphoma (CTCL), is associated with poor prognosis, with infections being the primary cause of mortality.
  • Polymorphonucleate granulocytes (PMNs) are crucial for innate immunity, combating pathogens via phagocytosis and killing, processes influenced by Toll-like receptor (TLR) and Pathogen-associated molecular pattern (PAMP) interactions.

Purpose of the Study:

  • To investigate the functional activity and phenotype of PMNs in SS patients.
  • To determine the correlation between PMN function and the incidence of infectious complications in SS.

Main Methods:

  • A prospective study involving 18 SS patients.
  • Evaluation of PMN phagocytic and intracellular killing activity against Klebsiella pneumoniae.
  • Flow cytometry analysis of PMN phenotype, including expression of CD11b, CD66b, CD62L, and TLRs (TLR2, 4, 5, 8, 9).

Main Results:

  • SS patients exhibited significantly reduced PMN phagocytic and intracellular killing activity against K. pneumoniae compared to healthy controls.
  • This functional impairment was more pronounced in SS patients experiencing recurrent infections.
  • PMN phenotype analysis revealed increased CD11b and CD66b expression and decreased CD62L expression in SS patients. TLR5 expression was elevated, while TLR2, 4, 8, and 9 expression showed no significant differences.
  • The observed impairment in PMN function in SS patients may contribute to immune suppression and increased susceptibility to infections.

Conclusions:

  • PMN functional impairment, including reduced phagocytosis and killing capacity, is a significant characteristic of Sézary syndrome.
  • Altered PMN phenotype and increased TLR5 expression are observed in SS patients.
  • These PMN defects likely contribute to the heightened risk of infections and poor outcomes in Sézary syndrome, underscoring the need for targeted immune support strategies.