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Following lymphocyte depletion, homeostatic mechanisms drive the reconstitution of lymphocytes. We prospectively studied this process in 16 patients for 1 year after a single pulse of treatment with Campath-1H, a humanised anti-CD52 monoclonal antibody. We observed two phases of lymphocyte reconstitution. In the first 6 months after treatment the precursor frequency and proliferation index of the patients' autologous mixed lymphocyte reaction increased; the depleted T cell pool was dominated by memory T cells, especially (CD4+)CD25high T cells, a putative regulatory phenotype; and there was a non-significant rise in peripheral mononuclear cell FoxP3 mRNA expression and fall in constitutive cytokine mRNA expression. In the later phase, from 6-to-12 months after Campath-1H, these changes reversed and there was a rise in ROG mRNA expression. However, total CD4+ numbers remained below 50% of pre-treatment levels at 12 months, perhaps reflecting a failure in homeostasis. This was not due to an impaired IL-7 response, as in rheumatoid arthritis, nor to a lack of IL-7 receptors, which are found on fewer human (CD4+)CD25high than naive cells. We speculate that CCL21 and IL-15 responses to lymphopaenia may be suboptimal in multiple sclerosis.

Original publication




Journal article


Eur J Immunol

Publication Date





3332 - 3342


Adult, Alemtuzumab, Antibodies, Monoclonal, Antibodies, Monoclonal, Humanized, Antibodies, Neoplasm, CD4-Positive T-Lymphocytes, Cell Proliferation, Cells, Cultured, Chemokine CCL21, Chemokines, CC, Female, Gene Expression Regulation, Homeostasis, Humans, Immunologic Memory, Interleukin-15, Interleukin-7, Lymphocyte Depletion, Male, Middle Aged, Multiple Sclerosis, Prospective Studies, Receptors, Interleukin-2, Receptors, Interleukin-7, Th1 Cells, Th2 Cells