title: Spontaneous B-cell IgE production in a patient with remarkable eosinophilia and hyper IgE.
abstract: BACKGROUND
  The pathophysiology of eosinophilia and hyper-IgE is not fully elucidated yet.
  
  
  OBJECTIVE
  To clarify the pathophysiology of a patient with remarkable eosinophilia and hyper IgE, we examined cytokine levels in serum, surface antigens of peripheral blood eosinophils and IgE production in vitro.
  
  
  RESULTS
  Concentrations of tumor necrosis factor-alpha (TNF-alpha), interleukin-3 (IL-3), interleukin-4 (IL-4), interleukin-5 (IL-5), and granulocyte/macrophage-colony stimulating factor (GM-CSF) in the serum were 21 pg/mL, <15 pg/mL, <15 pg/mL, 8 pg/mL, and <5 pg/mL pg/mL, respectively. Newly expressed surface antigens CD4, CD25, CD69, and HLA-DR, but not CD54, were observed on peripheral blood eosinophils. Extremely high levels of IgE secretion was found in the patient's mononuclear cells without stimuli; this was not enhanced by IL-4 or IL-4 plus anti-CD40 monoclonal antibody stimulation. Furthermore, highly purified B cells spontaneously produced large amounts of IgE and the production was not enhanced in addition of his T cells.
  
  
  CONCLUSIONS
  The eosinophils were activated, and the B cells spontaneously produced IgE independently of T cells or cytokines, suggesting that intrinsic abnormality of B cells leading to dysregulated production of IgE in this disease.
authors.affiliation: First Department of Internal Medicine, Shinshu University, School of Medicine, Matsumoto, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Takashi
authors.forename: Y
authors.initials: Y
authors.lastname: Okubo
authors.forename: S
authors.initials: S
authors.lastname: Horie
authors.forename: T
authors.initials: T
authors.lastname: Momose
authors.forename: A
authors.initials: A
authors.lastname: Tsukadaira
authors.forename: K
authors.initials: K
authors.lastname: Agematsu
authors.forename: M
authors.initials: M
authors.lastname: Sekiguchi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001402:B-Lymphocytes / Q000378:metabolism*; D004802:Eosinophilia / Q000150:complications / Q000378:metabolism* / Q000503:physiopathology; D006801:Humans; D006942:Hypergammaglobulinemia / Q000150:complications / Q000378:metabolism* / Q000503:physiopathology; D007073:Immunoglobulin E / Q000096:biosynthesis* / Q000097:blood*; D007963:Leukocytes, Mononuclear / Q000737:chemistry / Q000378:metabolism; D008297:Male
chemical_list: D007073:Immunoglobulin E