title: Immunoadsorption of immunoglobulins alters intracytoplasmic type 1 and type 2 T cell cytokine production in patients with refractory autoimmune diseases.
abstract: Intracellular cytokine staining and flow cytometry were used to investigate whether immunoadsorption (IA) of immunoglobulins alters intracytoplasmic cytokine production in CD4+ and CD8+ T cells from the blood of patients with refractory rheumatoid arthritis (n = 7), membrane proliferative glomerulonephritis (n = 1), and Goodpasture's syndrome (n = 1). Four patients (Group 1) showed severely depressed production of TNF-alpha, IL-2, IFN-gamma, and IL-4 by CD4+ and CD8+ T cells and responded to 3 IA sessions with significant increases in CD4+TNF-alpha+, CD4+IL-2+, and CD8+IL-2+ T cells. Also, a tendency toward increased percentage levels of CD4+ T cells producing IFN-gamma or IL-4 and of CD8+ T cells producing either TNF-alpha or IFN-gamma was seen, but due to the small number of patients investigated, these differences did not attain statistic significance. Group 2 (n = 5) showed unimpaired intracellular cytokine levels and responded to IA with a heterogeneous pattern of changes in TNF-alpha, IL-2, IFN-gamma, and IL-4 production, but these alterations were smaller than those in Group 1. The present findings indicate that the extracorporeal removal of immunoglobulins by anti-IgG or protein A adsorber columns has an impact on T cell immunity and suggest that modulating effects on cellular immune system function are involved in the mode of action of IA.
authors.affiliation: Institute of Diabetes Gerhardt Katsch Karlsburg, Germany.
authors.forename: B
authors.initials: B
authors.lastname: Hehmke
authors.forename: E
authors.initials: E
authors.lastname: Salzsieder
authors.forename: G B
authors.initials: GB
authors.lastname: Matic
authors.forename: R E
authors.initials: RE
authors.lastname: Winkler
authors.forename: M
authors.initials: M
authors.lastname: Tiess
authors.forename: W
authors.initials: W
authors.lastname: Ramlow
mesh_terms: D000328:Adult; D019867:Anti-Glomerular Basement Membrane Disease / Q000276:immunology / Q000378:metabolism / Q000628:therapy; D001172:Arthritis, Rheumatoid / Q000276:immunology / Q000378:metabolism / Q000628:therapy; D001327:Autoimmune Diseases / Q000276:immunology / Q000378:metabolism / Q000628:therapy*; D015496:CD4-Positive T-Lymphocytes / Q000378:metabolism*; D018414:CD8-Positive T-Lymphocytes / Q000378:metabolism*; D016207:Cytokines / Q000096:biosynthesis*; D005260:Female; D005434:Flow Cytometry; D015433:Glomerulonephritis, Membranous / Q000276:immunology / Q000378:metabolism / Q000628:therapy; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood*; D007163:Immunosorbent Techniques; D007371:Interferon-gamma / Q000096:biosynthesis; D007376:Interleukin-2 / Q000096:biosynthesis; D015847:Interleukin-4 / Q000096:biosynthesis; D008297:Male; D008875:Middle Aged; D010956:Plasmapheresis; D014409:Tumor Necrosis Factor-alpha / Q000096:biosynthesis
chemical_list: D016207:Cytokines; D007074:Immunoglobulin G; D007376:Interleukin-2; D014409:Tumor Necrosis Factor-alpha; D015847:Interleukin-4; D007371:Interferon-gamma