title: Enhancement of IL-1, IL-2 production and IL-2 receptor generation in patients with acute rheumatic fever and active rheumatic heart disease; a prospective study.
abstract: In a prospective study, patients with quiescent rheumatic heart disease (CRHD), streptococcal pharyngitis (SP) and healthy normal subjects produced comparable amounts of IL-1 and IL-2, but acute rheumatic fever (ARF) patients produced significantly elevated amounts of IL-1 and IL-2 at all intervals up to 48 weeks. In active rheumatic heart disease (ARHD), IL-1 activity returned to within normal range at 48 weeks, but IL-2 activity remained persistently elevated compared with CRHD, SP and healthy age- and sex-matched volunteers. CD4+ T lymphocytes were significantly increased in the peripheral blood of ARF and ARHD patients. The amount of IL-2 produced by ARF and ARHD patients correlated with the percentage of helper T lymphocytes (CD4+ cells) but not with the percentage of suppressor/cytotoxic T lymphocytes (CD8+ cells). Moreover, pre- and post-phytohaemagglutinin (PHA)-stimulated peripheral blood mononuclear cell (PBMC) cultures from ARF and ARHD patients contained higher proportions of IL-2R+ (CD25+) cells than those from patients with SP, CRHD and normal individuals, which persisted up to 48 weeks. The percentage of CD25+ cells in both types of PBMC cultures directly correlated with the percentage of CD4+ cells and not with CD8+ cells in active rheumatic patients only. These findings indicate that the immune response in ARF and ARHD patients is skewed to produce activated helper T cells that release IL-2 which drives the accumulation of more T helper cells. The result is an undamped helper T cell response in the peripheral blood of these patients.
authors.affiliation: Department of Experimental Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: K
authors.initials: K
authors.lastname: Morris
authors.forename: C
authors.initials: C
authors.lastname: Mohan
authors.forename: P L
authors.initials: PL
authors.lastname: Wahi
authors.forename: I S
authors.initials: IS
authors.lastname: Anand
authors.forename: N K
authors.initials: NK
authors.lastname: Ganguly
mesh_terms: D000293:Adolescent; D000328:Adult; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology; D002648:Child; D002908:Chronic Disease; D005260:Female; D006801:Humans; D007375:Interleukin-1 / Q000096:biosynthesis*; D007376:Interleukin-2 / Q000096:biosynthesis*; D008297:Male; D008875:Middle Aged; D009205:Myocarditis / Q000276:immunology; D010612:Pharyngitis / Q000276:immunology / Q000382:microbiology; D011446:Prospective Studies; D015375:Receptors, Interleukin-2 / Q000096:biosynthesis*; D012213:Rheumatic Fever / Q000276:immunology*; D012214:Rheumatic Heart Disease / Q000276:immunology*; D013290:Streptococcal Infections / Q000276:immunology; D013602:T-Lymphocytes, Cytotoxic / Q000276:immunology; D050378:T-Lymphocytes, Regulatory / Q000276:immunology
chemical_list: D007375:Interleukin-1; D007376:Interleukin-2; D015375:Receptors, Interleukin-2