title: The CD4+ T lymphocyte is a site of steroid resistance in asthma.
abstract: Phytohaemagglutinin (PHA)-induced T-cell proliferation is suppressed completely in steroid-sensitive asthma (SSA) by fluticasone propionate (FP). By contrast, in patients with steroid-resistant asthma (SRA), this proliferative response is only partially attenuated by steroids, which suggests that the T lymphocyte may harbour a key molecular defect in these patients. Both CD4+ and CD8+ T cells may be involved in orchestrating the inflammation underlying asthma. We examined whether CD4+ or CD8+ T cells isolated from SRA and SSA patients are equally susceptible to steroid suppression of PHA-induced proliferation. Complete suppression of CD4+ T-lymphocyte proliferation was seen in both SSA and control subjects at concentrations of 10(-9) M FP. In contrast, proliferation of CD4+ T cells from SRA patients was only partially inhibited, even at 10(-6) M FP. CD8+ responses from SRA, SSA and controls were all similar, with only a partial suppression of proliferation at 10(-6) M FP. Differential suppression by FP of CD4+ T cells has thus been demonstrated between SRA and SSA patients.
authors.affiliation: Molecular Medicine Unit, University of Leeds, St James's University Hospital, UK. rmrfs@stjames.leeds.ac.uk
authors.forename: F
authors.initials: F
authors.lastname: Syed
authors.forename: B
authors.initials: B
authors.lastname: Bingham
authors.forename: M
authors.initials: M
authors.lastname: Johnson
authors.forename: A F
authors.initials: AF
authors.lastname: Markham
authors.forename: J F
authors.initials: JF
authors.lastname: Morrison
mesh_terms: D000328:Adult; D000730:Androstadienes / Q000494:pharmacology*; D018927:Anti-Asthmatic Agents / Q000494:pharmacology*; D000893:Anti-Inflammatory Agents / Q000494:pharmacology*; D001249:Asthma / Q000276:immunology*; D015496:CD4-Positive T-Lymphocytes / Q000187:drug effects* / Q000276:immunology; D018929:Cell Culture Techniques; D002455:Cell Division / Q000187:drug effects; D004306:Dose-Response Relationship, Immunologic; D004351:Drug Resistance / Q000276:immunology; D005260:Female; D005434:Flow Cytometry; D000068298:Fluticasone; D006801:Humans; D008297:Male; D008875:Middle Aged; D010835:Phytohemagglutinins / Q000276:immunology
chemical_list: D000730:Androstadienes; D018927:Anti-Asthmatic Agents; D000893:Anti-Inflammatory Agents; D010835:Phytohemagglutinins; D000068298:Fluticasone