Efficacy of Interferon-Gamma Treatment in Bronchial Asthma / 결핵

BACKGROUND: There have been many in vitro evidences that interleukin-4(IL-4) might be the most important cytokine inducing IgE synthesis from B-cells, and interferon-gamma(IFN-gamma) might be a main cytokine antagonizing IL-4-mediated IgE synthesis. Recently some reports demonstrated that IFN-gamma might be used as a new therapeutic modality in some allergic diseases with high serum IgE level, such as atopic dermatitis or bronchial asthma. To evaluate the in vivo, effect of IFN-gamma in bronchial asthma we tried a clinical study. METHODS: Fifty bronchial asthmatics(serum, IgE level over 200 IU/ml) who did not respond to inhaled or systemic corticosteroid treatment, and 17 healthy nonsmoking volunteers were included in this study. The CD 23 expressions of peripheral B-cells, the IL-4 activities of peripheral T-cells, the serum soluble CD23(sCD23) levels, and the superoxide anton(O2-) generations by peripheral PMN were compared between bronchial asthmatics and normal subjects. The IL-4 activities of peripheral T-cells were analyzed by T-cell supernatant (T-sup)-induced CD23 expression from tonsil B-cells. In bronchial asthmatics the serum IgE levels and histamine PC. in addition to the above parameters were also compared before and after IFN-gamma treatment. IFN-gamma was administered subcutaneously with a weekly dose of 30,000 IU per kilogram of body weight for 4 weeks. RESULTS: The O2-, generations by peripheral PMNs in bronchial asthmatics were higher than normal subjects(8.23+/-0.94 vs 5.00+/-0.68 nmol/l x10(6) cells, P<0.05), and significantly decreased after IFN-gamma treatment compared to initial values(3.69+/-0.88 vs 8.61 +/- 1.53 nmol/l x 106 cells, P<0.05). CD23 expression of peripheral B-cells in bronchial asthmatics was higher than normal subjects(47.47 +/- 2.96% vs 31.62+/-1.92%, P<0.05), but showed no significant change after IFN-gammatreatment. The serum sCD23 levels in bronchial asthmatics were slightly higher than normal subjects( 191.04+/-23.3 U/ml vs 162.85+/-4.85 U/ml). and 11(64.7%) of 17 patients showed a decreasing pattern in their serum sCD23 levels after IFN-gamma treatment. However the means of serum sCD23 levels were not different before and after IFN-gamma treatment The IL-4 activities of peripheral T-cells in bronchial asthmatics were slightly higher than normal subjects 22.48 +/-6.81% vs 18.90+/-2.43%), and slightly increased after IFN-gamma treatment(27.90+/-2.56%). Nine(60%) of 15 patients showed a decreasing pattern in their serum IgE levels after IFN-gamma treatment. And the levels of serum IgE were significantly decreased after LEN-y treatment compared to initial values (658.67 +/- 120.84 IU/ml vs 1394.32 +/- 31442 IU/ml, P<0.05). Ten(83.3%) of 12 patients showed an improving pattern in bronchial hyperresponsiveness after IFN-gamma treatment, and the means of histamine PC20 were significantly increased after IFN-gamma treatment compared to initial values (1.22+/-0.29mg/ml vs 0.69+/-0.17mg/ml P<0.05). CONCLUSION: Our results suggest that IFN-gamma may k useful as well as safety in the treatment of bronchial asthmatics with high serum IgE level and that in vivo effects of IFN-gamma may be different from its in vitro effects on the regulations of IgE synthesis or the respiratory burst of PMN.

Expression of interleukin-6 in polymorphic reticulosis: immunohistochemical study of 5 cases

Peripheral T cell lymphoma encompasses lymphomas with a variety of histologic appearances and clinical patterns. Recently, it has been suggested that almost all of the histologic features described under the name of polymorphic reticulosis(PR), lethal midline granuloma, and midline malignant reticulosis can be included in those generally described for malignant lymphomas of peripheral T cell origin(PTCL). There have been few studies of pathogenesis or tissue damage mechanism in PR patients. The need for a precise mechanism for tissue damage has important therapeutic implications. Using immunohistochemical methods with polyclonal anti IL-6 antibody, the authors describe 5 cases of PR with clinically and pathologically typical PR demonstrating a high expression of IL-6. According to classification, 2 cases of grade 1 PR showed the highest expressions, and 2 cases of grade 2 PR with atypical lymphoid cells showed moderate activity, but one case progressed into frank lymphoma(grade 3) and lost IL-6 expression. This strongly implies that some cases of PR have a different mechanism of tissue damage from frank PTCL, despite the one disease spectrum. Further studies on more cases may help clarify the pathogenesis.