Nonmalignant BCells

The nonmalignant B-cell population (i.e., polyclonal cells) in B-CLL is not well characterized. The proportion and overall number of nonmalignant B-cells in patients with B-CLL is often significantly reduced. It has been postulated that this may, however, represent a dilutional effect. Regardless, B-cell function in many patients with B-CLL is abnormal, as exemplified by the frequent hypogammaglobulinemia and decreased antibody response to immunization seen in B-CLL patients. Multiple factors may contribute to the abnormal polyclonal B-cell function in B-CLL. As discussed above, CD95-CD95L interactions may contribute to the decreased number of antibody-producing cells in these patients (8). Also, CD5+ B-CLL cells can produce elevated levels of transforming growth factor-P, which may contribute to hyporesponsiveness of the normal B-cells (32). Since the autoantibodies responsible for the autoimmune disease are prob-

Table 3

Cytokine Production and Cytokine Receptor Changes in T- and B-CLL Cells of Patients With B-CLL

Table 3

Cytokine Production and Cytokine Receptor Changes in T- and B-CLL Cells of Patients With B-CLL

Cytokine alterations

CLL B-cells

T-cells

Elevated cytokine levelsa

IL-4, TGF-ß

IL-4, TNF-a, IL-2

Decreased cytokine levelsa

IL-10

Elevated cytokine receptor levels

CD25, CD119, CD124, IL-4 receptor,

IL-6 receptor, TNF receptor

IL, interleukin; TGF, transforming growth factor; TNF, tumor necrosis factor. Modified from ref. 33.

Cytokine alteraltions have been described as altered in the cell's culture medium or in the cytoplasm or in both.

IL, interleukin; TGF, transforming growth factor; TNF, tumor necrosis factor. Modified from ref. 33.

Cytokine alteraltions have been described as altered in the cell's culture medium or in the cytoplasm or in both.

ably produced by the residual pool of normal B-cells in B-CLL, further work needs to be done to examine the functional capacity of these B-cells. This work should provide additional clues regarding the etiology of these autoimmune disorders.

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