Immunomodulatory Mechanisms of Secondary Hemophagocytic Lymphohistiocytosis

Journal: Journal of Clinical Medicine Research DOI: 10.32629/jcmr.v6i2.4042

Ying Chang1, Yin Zhang2, Jing Tian1

1. School of Basic Medicine, Jinzhou Medical University, Jinzhou 121001, Liaoning, China
2. Department of Hematology, Jinzhou Central Hospital, Jinzhou 121001, Liaoning, China

Abstract

This study aims to comprehensively investigate the immunomodulatory mechanisms of secondary hemophagocytic lymphohistiocytosis (sHLH), focusing on cytokine and immune cell alterations to enhance diagnostic and treatment strategies. Through a systematic review of existing literature and clinical case analyses, we explored the roles of cytokines like IL-6, TNF-α, and IFN-γ, and immune cell changes in macrophages, T cells, and NK cells. We also examined the impact of genomic and epigenetic factors on sHLH pathogenesis. The results indicate that abnormal cytokine expression and immune cell dysfunction are central to sHLH development. Targeted therapies against specific cytokines show promise in managing sHLH. In conclusion, understanding these complex immunomodulatory mechanisms is crucial for developing more effective, personalized treatment plans to improve patient outcomes and survival rates. Future research should focus on standardized, multi-center studies to further elucidate these mechanisms and refine therapeutic approaches.

Keywords

secondary hemophagocytic lymphohistiocytosis; immunomodulation; cytokines; immune cells

References

[1]Gnanasambandam J, Geminiganesan S, Vilvanathan V, Sankaranarayanan S, Padmanabhan R. Secondary Hemophagocytic Lymphohistiocytosis - A Common Ramification of Different Diseases. EJIFCC. 2022;33(1):63-69. Published 2022 Apr. https://pubmed.ncbi.nlm.nih.gov/35645690/
[2]Kim JY, Kim M, Park JK, Lee EB, Park JW, Hong J. Limited efficacy of tocilizumab in adult patients with secondary hemophagocytic lymphohistiocytosis: a retrospective cohort study. Orphanet J Rare Dis. 2022;17(1):363. Published 2022 Sep 21. doi:10.1186/s13023-022-02516-1 https://pubmed.ncbi.nlm.nih.gov/36131317/
[3]Obeidat A, Al-Moussally F, Al Aruri DO, ALhomaimat E, Nader K. Unmasking the Culprits: A Case of Epstein-Barr Virus-Associated Hemophagocytic Lymphohistiocytosis Presenting With Mouth Ulcers and Nosebleeds. Cureus. 2024;16(6):e61822. Published 2024 Jun. doi:10.7759/cureus.61822 https://pubmed.ncbi.nlm.nih.gov/38975444/
[4]Hines MR, von Bahr Greenwood T, Beutel G, et al. Consensus-Based Guidelines for the Recognition, Diagnosis, and Management of Hemophagocytic Lymphohistiocytosis in Critically Ill Children and Adults. Crit Care Med. 2022;50(5):860-872. doi:10.1097/CCM.0000000000005361 https://pubmed.ncbi.nlm.nih.gov/34605776/
[5]Obeidat A, Al-Moussally F, Al Aruri DO, ALhomaimat E, Nader K. Unmasking the Culprits: A Case of Epstein-Barr Virus-Associated Hemophagocytic Lymphohistiocytosis Presenting With Mouth Ulcers and Nosebleeds. Cureus. 2024;16(6):e61822. Published 2024 Jun. doi:10.7759/cureus.61822 https://pubmed.ncbi.nlm.nih.gov/38975444/
[6]McKinnon AE. Hemophagocytic Lymphohistiocytosis Secondary to Miliary Tuberculosis in a Resource-Limited Setting: A Case Report. Cureus. 2024;16(11):e73733. Published 2024 Nov. doi:10.7759/cureus.73733 https://pubmed.ncbi.nlm.nih.gov/39677074/
[7]Tsuboi I, Harada T, Hirabayashi Y, Aizawa S. Senescence-accelerated mice (SAMP1/TA-1) treated repeatedly with lipopolysaccharide develop a condition that resembles hemophagocytic lymphohistiocytosis. Haematologica. 2019;104(10):1995-2005. doi:10.3324/haematol.2018.209551 https://pubmed.ncbi.nlm.nih.gov/30819910/
[8]Man C, Wang M, Yin G, et al. Clinical features of 47 secondary hemophagocytic lymphohistiocytosis patients complicated with capillary leak syndrome. Int J Hematol. 2021;113(2):263-270. doi:10.1007/s12185-020-03011-8 https://pubmed.ncbi.nlm.nih.gov/33037588/

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