The use of intravenous nitrogen-containing bisphosphonates (N-BPs) is associated with the appearance of an acute phase response (APR) in a proportion of the patients for reasons which are poorly understood. The APR was attributed to the indirect activation of γδ T cells with the release of interferon-γ and TNF. Forty patients with postmenopausal or senile osteoporosis (age range 53-91 years) never previously treated with intravenous (i.v.) bisphosphonate, received a single 5 mg zoledronic acid (ZOL) i.v. infusion over 15 min. White blood cells were counted and analysed with an automated haematology analyzer (ADVIA 2120i Siemens) and by flow cytometer (BD FACSCanto, Becton Dickinson). The occurrence of APR was defined by the occurrence of fever (> 37.0°C) during the next 2 days. Forty two % of patients (17/40) receiving the infusion of ZOL experienced an APR. As compared with the others they were younger (69 ± 7 years vs 74 ± 8 years; p = 0,06) and both the proportion and absolute number of γδ T cells were significant higher (p = 0,02 and p = 0,013, respectively). Non significant differences were found between the 2 groups for white blood cells and for the other circulating lymphocyte subpopulations. Age was inversely correlated with circulating γδ T cells (P= 0.003) but the difference between the two groups in circulating γδ T cells persisted for age adjusted values and vice-versa. In conclusion, the results of this study indicate that the number of circulating γδ T cells, together with age, are important determinant of the occurrence of APR after intravenous infusion of ZOL and possibly of any other N-BPs. © 2011 American Society for Bone and Mineral Research.
Circulating γδ T cells and the risk of acute-phase response after zoledronic acid administration.
ROSSINI, Maurizio;ADAMI, Silvano;Viapiana, O;GATTI, Davide
2012-01-01
Abstract
The use of intravenous nitrogen-containing bisphosphonates (N-BPs) is associated with the appearance of an acute phase response (APR) in a proportion of the patients for reasons which are poorly understood. The APR was attributed to the indirect activation of γδ T cells with the release of interferon-γ and TNF. Forty patients with postmenopausal or senile osteoporosis (age range 53-91 years) never previously treated with intravenous (i.v.) bisphosphonate, received a single 5 mg zoledronic acid (ZOL) i.v. infusion over 15 min. White blood cells were counted and analysed with an automated haematology analyzer (ADVIA 2120i Siemens) and by flow cytometer (BD FACSCanto, Becton Dickinson). The occurrence of APR was defined by the occurrence of fever (> 37.0°C) during the next 2 days. Forty two % of patients (17/40) receiving the infusion of ZOL experienced an APR. As compared with the others they were younger (69 ± 7 years vs 74 ± 8 years; p = 0,06) and both the proportion and absolute number of γδ T cells were significant higher (p = 0,02 and p = 0,013, respectively). Non significant differences were found between the 2 groups for white blood cells and for the other circulating lymphocyte subpopulations. Age was inversely correlated with circulating γδ T cells (P= 0.003) but the difference between the two groups in circulating γδ T cells persisted for age adjusted values and vice-versa. In conclusion, the results of this study indicate that the number of circulating γδ T cells, together with age, are important determinant of the occurrence of APR after intravenous infusion of ZOL and possibly of any other N-BPs. © 2011 American Society for Bone and Mineral Research.
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