The effect of treatment on lymphokine-secreting cells in the intestinal mucosa of children with Crohn's disease.
BACKGROUND
Recent studies have shown both interleukin 2 (IL-2) and interferon gamma (IFN) to be elevated in patients with active Crohn's disease compared to ulcerative colitis or non-inflammatory bowel disease controls. However the effect of treatment on these lymphokines has not been studied.


METHODS
Using a reverse haemolytic plaque assay the percentage of lymphokine-secreting cells was determined in the intestinal mucosa of children with Crohn's disease before and after 8 weeks of treatment with either enteral nutrition, cyclosporin or steroids.


RESULTS
Before treatment, a high percentage of cells isolated from mucosal biopsies secreted IL-2 or interferon-gamma. Eight weeks' treatment with the immunosuppressive agents cyclosporin, or with corticosteroids, produced a significant reduction in the percentage of IL-2 secreting cells, although only for the former was there also a reduction in interferon-gamma secreting cells. Enteral nutrition however, produced a reduction in lymphokine-secreting cells equivalent to cyclosporin and produced the best histological and clinical improvement.


CONCLUSIONS
Enteral nutrition and cyclosporin can down-regulate lymphokine secretion in the gut in Crohn's disease.
Breese
E J
EJ
Department of Paediatric Gastroenterology, St Bartholomew's Hospital, London, UK.
Michie
C A
CA
Nicholls
S W
SW
Williams
C B
CB
Domizio
P
P
Walker-Smith
J A
JA
MacDonald
T T
TT
D000293:Adolescent; D000893:Anti-Inflammatory Agents / Q000494:pharmacology*; D001707:Biopsy, Needle; D002648:Child; D003424:Crohn Disease / Q000188:drug therapy* / Q000378:metabolism*; D016572:Cyclosporine / Q000494:pharmacology*; D015536:Down-Regulation; D004750:Enteral Nutrition; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000494:pharmacology*; D007371:Interferon-gamma / Q000378:metabolism*; D007376:Interleukin-2 / Q000378:metabolism*; D007413:Intestinal Mucosa / Q000166:cytology / Q000187:drug effects* / Q000378:metabolism; D008297:Male; D011239:Prednisolone / Q000494:pharmacology*; D013601:T-Lymphocytes / Q000187:drug effects*
D000893:Anti-Inflammatory Agents; D007166:Immunosuppressive Agents; D007376:Interleukin-2; D007371:Interferon-gamma; D016572:Cyclosporine; D011239:Prednisolone