title: Th2 dominance in nasal mucosa in patients with Wegener's granulomatosis.
abstract: Wegener's granulomatosis initially affects upper respiratory tract organs including the nasal mucosa in more than 90% of patients. The inflammation is typically granulomatous with associated vasculitis. T lymphocytes are usually a prominent component of the leucocyte infiltrate. Previous studies using peripheral blood T cells have implicated IFN-gamma rich Th1-type responses. This study addressed the cytokine milieu in nasal mucosa from 10 patients with active Wegener's granulomatosis using immunohistochemistry. Increased levels of CD3+ T cells and eosinophils were present compared with normal and disease controls. There was increased expression of IL-4, down-regulation of IL-2 and no detectable IFN-gamma. There was increased expression of the chemokine receptor CCR3 by infiltrating cells, consistent with an IL-4 dominant, Th2-biased response. In contrast, renal biopsy tissue from 10 patients with active Wegener's granulomatosis showed expression of IL-2 and IL-4. The Th2-type environment within nasal mucosa, often the initial site of disease activity in Wegener's, is consistent with a local allergic response in these patients.
authors.affiliation: Renal Immunobiology Laboratory, Division of Medical Sciences, MRC Centre for Immune Regulation, The Medical School, University of Birmingham, Birmingham, UK.
authors.forename: C E
authors.initials: CE
authors.lastname: Balding
authors.forename: A J
authors.initials: AJ
authors.lastname: Howie
authors.forename: A B
authors.initials: AB
authors.lastname: Drake-Lee
authors.forename: C O
authors.initials: CO
authors.lastname: Savage
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001706:Biopsy; D017252:CD3 Complex / Q000032:analysis / Q000276:immunology; D002478:Cells, Cultured; D016207:Cytokines / Q000096:biosynthesis / Q000235:genetics / Q000276:immunology; D005260:Female; D014890:Granulomatosis with Polyangiitis / Q000276:immunology* / Q000473:pathology; D006801:Humans; D018928:Immunity, Mucosal; D007150:Immunohistochemistry; D007668:Kidney / Q000276:immunology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D053146:Myeloblastin; D009297:Nasal Mucosa / Q000276:immunology* / Q000473:pathology; D012333:RNA, Messenger / Q000096:biosynthesis; D012697:Serine Endopeptidases / Q000494:pharmacology; D018417:Th1 Cells / Q000187:drug effects / Q000276:immunology; D018418:Th2 Cells / Q000187:drug effects / Q000276:immunology*
chemical_list: D017252:CD3 Complex; D016207:Cytokines; D012333:RNA, Messenger; D012697:Serine Endopeptidases; D053146:Myeloblastin