title: Plasmapheresis modulates Th1/Th2 imbalance in patients with systemic lupus erythematosus according to measurement of intracytoplasmic cytokines.
abstract: To examine the possible effect of plasmapheresis on the ratio of Th1/Th2 type cytokine-secreting cells we recruited eight patients with active systemic lupus erythematosus into the present study. They all failed to respond to conventional therapy. A sensitive multiparametric flow cytometric analysis was used for the detection of intracellular IL-4, IL-10 and IFNgamma. Stimulated peripheral blood cells were analysed by this procedure. Plasmapheresis was performed every second day for three occasions, using a continuous flow type blood cell separator, and a total of 100 ml/body weight kg plasma was removed. Patients received 1 mg/kg/day methylprednisolone during this period. As a result of the procedure, the rate of IFNgamma positive Th cells increased, while the rate of IL-4 and IL-10 expressing CD4 positive cells decreased. Together with these observations the concentration of anti-ds-DNA antibodies decreased after plasmapheresis. A decrease in disease activity index (SLE-DAI) indicated the clinical effectiveness of the therapy.
authors.affiliation: Third Department of Internal Medicine, Medical and Health Science Centre of the Medical University of Debrecen, Hungary.
authors.forename: Pál
authors.initials: P
authors.lastname: Soltész
authors.forename: Magdolna
authors.initials: M
authors.lastname: Aleksza
authors.forename: Péter
authors.initials: P
authors.lastname: Antal-Szalmás
authors.forename: Gabriella
authors.initials: G
authors.lastname: Lakos
authors.forename: Gyula
authors.initials: G
authors.lastname: Szegedi
authors.forename: Emese
authors.initials: E
authors.lastname: Kiss
mesh_terms: D000293:Adolescent; D000328:Adult; D000974:Antibodies, Antinuclear / Q000097:blood; D016022:Case-Control Studies; D016207:Cytokines / Q000097:blood*; D003593:Cytoplasm / Q000276:immunology; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D007371:Interferon-gamma / Q000097:blood; D016753:Interleukin-10 / Q000097:blood; D015847:Interleukin-4 / Q000097:blood; D008180:Lupus Erythematosus, Systemic / Q000276:immunology* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010956:Plasmapheresis; D018417:Th1 Cells / Q000276:immunology*; D018418:Th2 Cells / Q000276:immunology*
chemical_list: D000974:Antibodies, Antinuclear; D016207:Cytokines; D016753:Interleukin-10; D015847:Interleukin-4; D007371:Interferon-gamma