High incidence of glucose intolerance in Vogt-Koyanagi-Harada disease.

AIMS: To evaluate glucose tolerance of patients with Vogt-Koyanagi-Harada (VKH) disease before systemic corticosteroid therapy, and to assess changes brought on by treatment. METHODS: 20 VKH patients with acute bilateral panuveitis were studied. 20 healthy adults and 11 Behçet's disease patients with active uveoretinitis served as controls. A 75 g oral glucose tolerance test (OGTT) was given in the acute stage of ocular inflammation before systemic corticosteroid therapy. The OGTT was repeated in the convalescent stage of VKH disease in the patients with glucose intolerance before treatment. Insulin response was examined at the same time as the OGTT when possible. RESULTS: 55% of VKH patients (11/20) showed glucose intolerance but no apparent insulin secretion deficiency was detected. Four of seven patients in the convalescent stage showed improvement of glucose tolerance. None of the normal controls or disease controls showed glucose intolerance. CONCLUSION: A high incidence of glucose intolerance was found in the acute stage of VKH disease. However, glucose intolerance improved in most cases after systemic corticosteroid therapy. It is possible that glucose intolerance seen in VKH patients may be related to the autoimmune inflammatory process of this disease.

Increased frequencies of interleukin-2- and interferon-gamma-producing T cells in patients with active Behçet's disease.

PURPOSE: To elucidate the profile of cytokine-producing T cells in patients with active or inactive Behçet's disease (BD), the frequencies of type 1 (Interleukin- [IL] 2, interferon-gamma [IFN-gamma]) and type 2 (IL-4) cytokine-producing CD4+ and CD8+ cells in peripheral blood were investigated, and the effect of immunosuppressive drugs on the profile of cytokine-producing cells was evaluated. METHODS: Fifty-two patients with BD (32 with active and 20 with inactive BD) and 33 healthy control subjects were the subjects in this study. Patients were or were not treated with immunosuppressive drugs. Peripheral blood mononuclear cells were fixed, permeabilized, and stained for intracellular cytokines in combination with cell surface markers CD4 and CD8 for flow cytometric analysis. RESULTS: In nontreated patients with BD, the frequencies of IL-2- and IFN-gamma-producing CD4 and CD8+ cells in active patients were significantly higher than those in inactive patients. Conversely, the frequencies of IL-4 producing CD4+ and CD8+ cells in nontreated patients with active BD were comparable with those in patients with inactive disease and in control subjects. Patients with inactive BD who were treated with immunosuppressive drugs showed significantly lower frequencies of IL-2- and IFN-gamma-producing CD4+ and CD8+ cells than did treated patients with active BD. CONCLUSIONS: The frequencies of type 1 cytokine-producing CD4+ and CD8+ cells increased in patients with active BD. Effective immunosuppressive treatments decreased the population of type 1 cytokine-producing CD4+ and CD8+ cells. These results suggest that type 1 cytokine-producing cells play an important role in the immunopathogenesis of the inflammation in BD.