Research Article
Volume 3 Issue 4 - 2021
Changes in Immune Phenotypes of Peripheral Blood Lymphocytes (PBLs) among Occupationally Cytostatic Exposed Hospital Employees
Anna Tompa1*, Miklós Zrínyi2 and Anna Biro3
1Semmelweis University, Institute of Public Health, Budapest, Hungary
2National Public Health Center, Toxicology Laboratory Department, Budapest, Hungary
3National Public Health Center, Toxicology Laboratory Department, Budapest, Hungary
*Corresponding Author: Anna Tompa, Semmelweis University, Institute of Public Health, Budapest, Hungary.
Received: January 27, 2021; Published: March 31, 2021


Health professionals who had been working in different health care units and who were chronically exposed to cytostatic drugs were examined during the last 25 years. In their working area of the oncology outpatient and hospital units cytostatic drug exposure regularly exceeded safety limits due to the lack of proper safety devices. Their health condition was annually investigated by clinics, and it was found that they developed more hematological, immunological and reproductive alterations. In the present study we assessed changes in immune phenotypes based on the CD4/CD8 T-cells ratio, B and NK cell percentages measured by FACS methodology. The investigations were carried out in 550 subjects exposed to different cytostatic agents in oncology departments. Data were compared to age matched 83 healthy and non-exposed female controls. Biomarkers were measured by routine clinical laboratory tests, completed with immune phenotyping and measured in peripheral blood lymphocytes (PBL). Health personnel exposed to different agents showed increased ratio of CD4/CD8 T-cell and a decrease in activated T-cells. Beside these parameters we found an elevation of B-cells and a decrease in NK-cells. Within the exposed groups smokers showed even stronger decreased NK-cell counts compared to non-smokers. These changes in immune-phenotypes may give us a new biomarker immune suppression of PBL-cells among nurses after toxic exposures in their working environment.

Keywords: Occupational Exposure of Cytostatic Drugs; Immune Depression; CD4/CD8 Ratio; NK-Cells; B-Cells


    1. Aw D and Silva AB. “Immune senescence emerging challenges for an ageing population”. Immunology 120 (2007): 435-446.
    2. Biro A., et al. “Immunotoxicity Monitoring of Hospital Staff Occupationally Exposed to Cytostatic Drugs”. Pathology Oncology Research 17 (2011): 301-308.
    3. Biro A and Tompa A. “Life Style Factors Influencing Immunotoxic Effects Detected on Peripheral Blood Lymphocytes of Health Personnel Exposed to Anesthetic Gas (2013)”. Clinical and Experimental Pharmacology S4 (2013): 2161-1459.
    4. Carrano AV and Natarajan AT. “Considerations on population monitoring using cytogenetic techniques. ICPEMC Publ.No.14”. Mutation Research 204 (1988): 379-406.
    5. Condore G., et al. “Biology of longevity: role of the innate immune system”. Rejuvenation Research 1 (2006): 143-148.
    6. Epel ES., et al. “Accelerated telomere shortening in response to life stress”. Proceedings of the National Academy of Sciences of the United States of America 49 (2004): 17312-1715.
    7. Hakin FT and Gress RE. “Immune senescence: deficit in adaptive immunity in elderly”. Tissue Antigens3 (2007): 179-189.
    8. Hayflick L and Moorhead P. “The serial cultivation of human diploid cell strains”. Experimental Cell Research3 (1961): 585-621.
    9. Kiecolt-Glaser JK., et al. “Chronic stress and age – related increases in the proinflammatory cytokine IL-6”. Proceedings of the National Academy of Sciences of the United States of America 15 (2003): 9090-9095.
    10. Koch S., et al. “Multiparameter flow cytometric analysis of CD4 and CD8-T cell subsets in young and old people”. Immunity and Ageing 5 (2008): 6.
    11. Lewis DE., et al. “Tumor necrosis factor alpha and CD80 modulate CD28 expression through a similar mechanism of T-cell receptor-independent inhibition of transcription”. Journal of Biological Chemistry 28 (2004): 29130-29138.
    12. Phelouzat MA., et al. “Excessive apoptosis of mature T lymphocytes is a characteristic feature of human immune senescence”. Science Direct1-2 (1996): 25-38.
    13. Pole A., et al. “Oxidative stress, cellular senescence and ageing”. AIMS Molecular Science 3 (2016): 300-324.
    14. Tannenbaum TN and Goldberg RJ. “Exposure to anesthetic gases and reproductive outcome: a review of the epidemiologic literature”. Journal of Occupational and Environmental Medicine 27 (1985): 659-668.
    15. Tompa A., et al. “Chemical Safety and Health Conditions among Hungarian Hospital Nurses”. Annals New York Academy of Acience 1076 (2006): 635-648.
    16. Tompa A. “Hospital workplaces: risks of exposure to carcinogens”. Hospital Pharmacy Europe 36 (2008): 29-31.
    17. Tompa A., et al. “Genotoxic Monitoring of Nurses Handling Cytotoxic Drugs”. Asia-Pacific Journal of Oncology Nursing4 (2016): 365-369.
    18. Van de Veen W., et al. “Role of regulatory B cells in immune tolerance to allergens and beyond”. The Journal of Allergy and Clinical Immunology 3 (2016): 654-665.
    19. Klinker MW and Lundy SK. “Multiple mechanisms of immune suppression by B lymphocytes”. Molecular Medicine 18 (2012): 123-137.
    20. Elshaer NS. “Adverse health effects among nurses and clinical pharmacists handling antineoplastic drugs: Adherence to exposure control methods” (2017).
    21. Gajski G., et al. “Genotoxicity assessment of selected cytostatic drug mixture in human lymphocytes: A study based on concentration relevant for occupational exposure”. Environmental Research 161 (2018): 26-34.
Citation: Anna Tompa., et al. “Changes in Immune Phenotypes of Peripheral Blood Lymphocytes (PBLs) among Occupationally Cytostatic Exposed Hospital Employees”. EC Nursing and Healthcare 3.4 (2021): 245-250.

PubMed Indexed Article

EC Pharmacology and Toxicology
LC-UV-MS and MS/MS Characterize Glutathione Reactivity with Different Isomers (2,2' and 2,4' vs. 4,4') of Methylene Diphenyl-Diisocyanate.

PMID: 31143884 [PubMed]

PMCID: PMC6536005

EC Pharmacology and Toxicology
Alzheimer's Pathogenesis, Metal-Mediated Redox Stress, and Potential Nanotheranostics.

PMID: 31565701 [PubMed]

PMCID: PMC6764777

EC Neurology
Differences in Rate of Cognitive Decline and Caregiver Burden between Alzheimer's Disease and Vascular Dementia: a Retrospective Study.

PMID: 27747317 [PubMed]

PMCID: PMC5065347

EC Pharmacology and Toxicology
Will Blockchain Technology Transform Healthcare and Biomedical Sciences?

PMID: 31460519 [PubMed]

PMCID: PMC6711478

EC Pharmacology and Toxicology
Is it a Prime Time for AI-powered Virtual Drug Screening?

PMID: 30215059 [PubMed]

PMCID: PMC6133253

EC Psychology and Psychiatry
Analysis of Evidence for the Combination of Pro-dopamine Regulator (KB220PAM) and Naltrexone to Prevent Opioid Use Disorder Relapse.

PMID: 30417173 [PubMed]

PMCID: PMC6226033

EC Anaesthesia
Arrest Under Anesthesia - What was the Culprit? A Case Report.

PMID: 30264037 [PubMed]

PMCID: PMC6155992

EC Orthopaedics
Distraction Implantation. A New Technique in Total Joint Arthroplasty and Direct Skeletal Attachment.

PMID: 30198026 [PubMed]

PMCID: PMC6124505

EC Pulmonology and Respiratory Medicine
Prevalence and factors associated with self-reported chronic obstructive pulmonary disease among adults aged 40-79: the National Health and Nutrition Examination Survey (NHANES) 2007-2012.

PMID: 30294723 [PubMed]

PMCID: PMC6169793

EC Dental Science
Important Dental Fiber-Reinforced Composite Molding Compound Breakthroughs

PMID: 29285526 [PubMed]

PMCID: PMC5743211

EC Microbiology
Prevalence of Intestinal Parasites Among HIV Infected and HIV Uninfected Patients Treated at the 1o De Maio Health Centre in Maputo, Mozambique

PMID: 29911204 [PubMed]

PMCID: PMC5999047

EC Microbiology
Macrophages and the Viral Dissemination Super Highway

PMID: 26949751 [PubMed]

PMCID: PMC4774560

EC Microbiology
The Microbiome, Antibiotics, and Health of the Pediatric Population.

PMID: 27390782 [PubMed]

PMCID: PMC4933318

EC Microbiology
Reactive Oxygen Species in HIV Infection

PMID: 28580453 [PubMed]

PMCID: PMC5450819

EC Microbiology
A Review of the CD4 T Cell Contribution to Lung Infection, Inflammation and Repair with a Focus on Wheeze and Asthma in the Pediatric Population

PMID: 26280024 [PubMed]

PMCID: PMC4533840

EC Neurology
Identifying Key Symptoms Differentiating Myalgic Encephalomyelitis and Chronic Fatigue Syndrome from Multiple Sclerosis

PMID: 28066845 [PubMed]

PMCID: PMC5214344

EC Pharmacology and Toxicology
Paradigm Shift is the Normal State of Pharmacology

PMID: 28936490 [PubMed]

PMCID: PMC5604476

EC Neurology
Examining those Meeting IOM Criteria Versus IOM Plus Fibromyalgia

PMID: 28713879 [PubMed]

PMCID: PMC5510658

EC Neurology
Unilateral Frontosphenoid Craniosynostosis: Case Report and a Review of the Literature

PMID: 28133641 [PubMed]

PMCID: PMC5267489

EC Ophthalmology
OCT-Angiography for Non-Invasive Monitoring of Neuronal and Vascular Structure in Mouse Retina: Implication for Characterization of Retinal Neurovascular Coupling

PMID: 29333536 [PubMed]

PMCID: PMC5766278

EC Neurology
Longer Duration of Downslope Treadmill Walking Induces Depression of H-Reflexes Measured during Standing and Walking.

PMID: 31032493 [PubMed]

PMCID: PMC6483108

EC Microbiology
Onchocerciasis in Mozambique: An Unknown Condition for Health Professionals.

PMID: 30957099 [PubMed]

PMCID: PMC6448571

EC Nutrition
Food Insecurity among Households with and without Podoconiosis in East and West Gojjam, Ethiopia.

PMID: 30101228 [PubMed]

PMCID: PMC6086333

EC Ophthalmology
REVIEW. +2 to +3 D. Reading Glasses to Prevent Myopia.

PMID: 31080964 [PubMed]

PMCID: PMC6508883

EC Gynaecology
Biomechanical Mapping of the Female Pelvic Floor: Uterine Prolapse Versus Normal Conditions.

PMID: 31093608 [PubMed]

PMCID: PMC6513001

EC Dental Science
Fiber-Reinforced Composites: A Breakthrough in Practical Clinical Applications with Advanced Wear Resistance for Dental Materials.

PMID: 31552397 [PubMed]

PMCID: PMC6758937

EC Microbiology
Neurocysticercosis in Child Bearing Women: An Overlooked Condition in Mozambique and a Potentially Missed Diagnosis in Women Presenting with Eclampsia.

PMID: 31681909 [PubMed]

PMCID: PMC6824723

EC Microbiology
Molecular Detection of Leptospira spp. in Rodents Trapped in the Mozambique Island City, Nampula Province, Mozambique.

PMID: 31681910 [PubMed]

PMCID: PMC6824726

EC Neurology
Endoplasmic Reticulum-Mitochondrial Cross-Talk in Neurodegenerative and Eye Diseases.

PMID: 31528859 [PubMed]

PMCID: PMC6746603

EC Psychology and Psychiatry
Can Chronic Consumption of Caffeine by Increasing D2/D3 Receptors Offer Benefit to Carriers of the DRD2 A1 Allele in Cocaine Abuse?

PMID: 31276119 [PubMed]

PMCID: PMC6604646

EC Anaesthesia
Real Time Locating Systems and sustainability of Perioperative Efficiency of Anesthesiologists.

PMID: 31406965 [PubMed]

PMCID: PMC6690616

EC Pharmacology and Toxicology
A Pilot STEM Curriculum Designed to Teach High School Students Concepts in Biochemical Engineering and Pharmacology.

PMID: 31517314 [PubMed]

PMCID: PMC6741290

EC Pharmacology and Toxicology
Toxic Mechanisms Underlying Motor Activity Changes Induced by a Mixture of Lead, Arsenic and Manganese.

PMID: 31633124 [PubMed]

PMCID: PMC6800226

EC Neurology
Research Volunteers' Attitudes Toward Chronic Fatigue Syndrome and Myalgic Encephalomyelitis.

PMID: 29662969 [PubMed]

PMCID: PMC5898812

EC Pharmacology and Toxicology
Hyperbaric Oxygen Therapy for Alzheimer's Disease.

PMID: 30215058 [PubMed]

PMCID: PMC6133268

News and Events

May Issue Release

We always feel pleasure to share our updates with you all. Here, notifying you that we have successfully released the May issue of respective journals and the latest articles can be viewed on the current issue pages.

Submission Deadline for Upcoming Issue

ECronicon delightfully welcomes all the authors around the globe for effective collaboration with an article submission for the upcoming issue of respective journals. Submissions are accepted on/before May 25, 2022.

Certificate of Publication

ECronicon honors with a "Publication Certificate" to the corresponding author by including the names of co-authors as a token of appreciation for publishing the work with our respective journals.

Best Article of the Issue

Editors of respective journals will always be very much interested in electing one Best Article after each issue release. The authors of the selected article will be honored with a "Best Article of the Issue" certificate.

Certifying for Review

ECronicon certifies the Editors for their first review done towards the assigned article of the respective journals.

Latest Articles

The latest articles will be updated immediately on the articles in press page of the respective journals.