Table 2.
Potential impact of treatment with BTK inhibitors on infectious susceptibility.
| Cell type | Biological function | BTKi impact on cell number/function | On-target effect | Off-target effect | Potentially increased risk of infection by |
|---|---|---|---|---|---|
| ADAPTIVE IMMUNE SYSTEM | |||||
| T cells | |||||
| CD8+ | cytotoxic activity | decrease | X | virus, bacteria | |
| CD4+ | helper function in Ag presentation |
decrease | X | virus, bacteria | |
| Th1 | promotion of cellular immunity | increase/decrease | X | intracellular pathogens | |
| Th2 | promotion of humoral immunity | decrease | X | Extracellular pathogens, parasites | |
| Th17 | promotion of tissue inflammation, neutrophils recrutiment | decrease | X | extracellular bacteria and fungi | |
| B cells | IgG production | X | bacteria, opportunistic pathogens | ||
| INNATE IMMUNE SYSTEM | |||||
| NK | Cytotoxic activity | decrease | X | Viruses, intracellular bacteria | |
| ADCC | X | ||||
| Neutrophils | Ag recognition | decrease | X | Bacteria, fungi | |
| maturation | X | ||||
| degranulation | X | ||||
| Monocytes/Macrophages | Ag presentation | decrease | X | X (?) | Bacteria, fungi |
| phagocytosis and cytokine secretion | X | ||||
| Mast cells | degranulation and cytokine production | decrease | X | X | parasites |
| γδ T cells | degranulation | decrease | ? | ? | |
Ag, antigen; Th1, type 1 T-helper; Th2, type 2 T-helper; Ig, immunoglobulin; NK, natural killer; ADCC, antibody-dependent cellular cytotoxicity; Ag, antigen.