FIGURE 4.

Ibrutinib affects the anti-fungal activities of NLC. (A) Bar diagram shows the percentage of hyphal damage induced by NLC either treated or not with ibrutinib (n = 5,**P < 0.01). (B) Photomicrographs show the growth of A. fumigatus onto NLC previously treated overnight with ibrutinib in two representative CLL patients. (C) NLC obtained from eight CLL patients were treated or not with ibrutinib overnight, followed by phagocytosis assay. Bar diagram depicts the reduction in phagocytic ability expressed in fold change induced by ibrutinib in NLC (*P < 0.05). (D) Circulating CD14+ CLL monocytes were pre-treated with ibrutinib for 1 h and then stimulated with zymosan particles labeled with a red dye. The phagocytic activity of monocytes was measured by flow cytometry gating CD11b+ CD14+ population. Ibrutinib significantly affected the ability of monocytes to engulf zymosan particles (n = 7, *P < 0.01). (E) CD14+ HD monocytes were pre-treated with ibrutinib for 1 h and then stimulated with zymosan particles labeled with a red dye. The phagocytic activity of monocytes was measured by flow cytometry (n = 9, **P < 0.01). Lines show the reduction in engulfment ability induced by ibrutinib.