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* = Presenting author

P469 Changes in peripheral blood lymphocyte subsets induced by azathioprine in Crohn’s disease patients

A. Labidi*, M. Fekih, N. Ben Mustapha, S. Ben Amor, M. Serghini, L. Kallel, J. Boubaker, A. Filali

La Rabta University Hospital, Gastroenterology, Tunis, Tunisia

Background

Azathioprine (AZT) is an immunosuppressive drug used in chronic inflammatory diseases such as Crohn’s disease. It has been suggested that its molecular mechanism of action consisted in inducing apoptosis of T-cells. Our goal was to determine whether azathioprine (AZT) modulates peripheral blood lymphocyte subsets (PBLS) in Crohn’s disease (CD) patients.

Methods

We conducted a prospective study including CD outpatients during a 6-month period. We excluded patients who were put on immunosuppressive drugs other than azathioprine. We assessed absolute CD3(+), CD3(+)CD4(+), and CD3(+)CD8(+) PBLS counts and CD4/CD8 ratios for patients who were put on AZT (AZT+) and those who did not take AZT(AZT-). Both groups (AZT+) and (AZT-) were compared to assess the effect of AZT on PBLS. Statistical analysis was performed using SPSS version 21.0.

Results

We included 62 patients. There were 21 males and 41 females of a mean age of 32.3 years old (8–61 years old). AZT was administered by 42 patients. Both groups, (AZT+) and (AZT-), were comparable with regard to age and sex. Comparison of both groups showed a significant decrease in absolute total lymphocyte count (1 368/mm3 vs 1 769/mm3, p = 0.014) and in PBLS counts in the (AZT+) group versus the (AZT-) group: CD3(+)(762/mm3 vs 1060/mm3, p = 0.006), CD3(+)CD4(+) (430/mm3 vs 555/mm3, p = 0.036), and CD3(+)CD8(+)(296/mm3 vs 412/mm3, p = 0.04). However, CD4/CD8 ratio was roughly the same in both groups (1.6 vs 1.5, p = 0.63), in (AZT+) and (AZT-), respectively.

Conclusion

Our findings suggest that AZT reduces PBLS counts in CD patients. However, the balance between CD3(+)CD4(+) and CD3(+)CD8(+) is maintained. Larger studies are needed to confirm these results.