Danazol increases T regulatory cells in patients with aplastic anemia

Harshit Khurana, Pankaj Malhotra, Man Updesh Sachdeva, Man Updesh Singh Sachdeva, Neelam Varma, Parveen Bose, Uday Yanamandra, Subhash Varma, Alka Khadwal, Deepesh Lad, Gaurav Prakash
Hematology (Amsterdam, Netherlands) · 2018 · vol. 23(8) , pp. 496–500 · doi:10.1080/10245332.2018.1435045 · PMID:29415633 · W2792759591
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This study found that patients with aplastic anemia have lower T regulatory cells than healthy controls, and Danazol treatment significantly increases these cells in patients.

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Abstract

OBJECTIVES: Danazol is an attenuated androgen and is used in the treatment of aplastic anemia (AA) in resource constraint settings. We chose to study the role of CD4+ CD25high CD127low FoxP3+ T regulatory cells (T-regs) in the pathophysiology of AA and their response to treatment with Danazol alone or in combination with immunosuppressive treatment (IST). METHODS: T-regs' percentages of 25 acquired idiopathic AA patients and 25 healthy controls who completed study protocol were analyzed by performing multicolor flowcytometry on peripheral blood samples. RESULTS: More than one-third (36%) of AA patients in our study received Danazol as monotherapy, whereas less than a third (32%) each received standard doses of IST with equine Anti Thymocyte Globulin (ATG) and Cyclosporine combination, or Cyclosporine and Danazol combination, respectively. Results showed that all AA patients had a significantly lower percentage of T-regs at the time of diagnosis when compared to healthy controls (p < 0.0001), implicating their role in the pathophysiology. On treatment, all 25 patients showed a significant rise in the percentage of T-regs when compared to baseline (p < 0.0001). DISCUSSION: The rise in T-regs' percentage was higher in patients treated with Danazol alone when compared to standard IST (ATG with Cyclosporine), or Cyclosporine with Danazol combinations (p = 0.585). CONCLUSION: We conclude that Danazol also leads to increase in T-regs in acquired idiopathic AA.

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MeSH descriptors

Anemia, Aplastic Anemia, Aplastic Danazol T-Lymphocytes, Regulatory Adolescent Adult Aged Anemia, Aplastic Antilymphocyte Serum Antilymphocyte Serum Cyclosporine Cyclosporine Danazol Female Humans Male Middle Aged Prospective Studies T-Lymphocytes, Regulatory

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