BACKGROUND: Currently, C5 complement inhibitors serve as the first-line therapy for classic paroxysmal nocturnal hemoglobinuria (PNH), effectively controlling hemolysis and enhancing patients' quality of life. However, the impact of this treatment on patients' immune status remains unclear. METHODS: A retrospective analysis was conducted on 27 PNH patients treated with C5 complement inhibitors, focusing on the dynamic changes and recovery of key immune cell subsets, including T lymphocytes, B lymphocytes, natural killer (NK) cells, and dendritic cells (DCs). RESULTS: T lymphocytes was markedly elevated in pre-treatment patients compared with controls (49.38 ± 7.259)% vs. (41.75 ± 4.744)%, p < 0.01, and it returned to near-normal levels at 12 months (42.97 ± 7.074)%. The proportion of B lymphocytes was significantly reduced in pre-treatment PNH patients (6.535 ± 1.854)% vs. (12.70 ± 2.256)% in controls, p < 0.001 and partially recovered at 6, 12, and 24 months post-treatment (8.266 ± 1.756)%, (8.626 ± 1.649)%, and (8.559 ± 1.697)% respectively, though it did not reach normal levels. No significant changes were observed in Treg cells, NK cells, and DCs after treatment. CONCLUSIONS: This is the first study to systematically analyze immune status alterations following C5 complement inhibitor treatment in PNH patients, suggesting that the complement system may be involved in the development of immune escape mechanisms in PNH.
Liu et al. (Wed,) studied this question.