title: Clinical relevance of balance between type 1 and type 2 immune responses of lymphocyte subpopulations in aplastic anaemia patients.
abstract: Immune dysfunction, which leads to the suppression of haemopoiesis by cytokines that are secreted by activated T lymphocytes, is considered to play a key role in the pathogenesis of acquired aplastic anaemia (AAA). We investigated the intracytoplasmic expression of type-1 [interferon gamma (IFN-gamma), interleukin (IL)-2] and type-2 (IL-4, IL-10) cytokines in CD4+ and CD8+ T cells before and after in vitro activation in 16 patients with AAA and 17 normal controls. Untreated or refractory patients had a significantly higher proportion of unstimulated CD4+ and CD8+ T cells that produced IFN-gamma and IL-2 whereas the IL-4 and IL-10 producing T cells did not differ from that of controls, resulting in a shift of IFN-gamma/IL-4 ratio towards a type-1 response. Patients in remission had also increased proportion of IFN-gamma-producing unstimulated CD4+ and CD8+ cells, with a parallel rise of IL-4- and IL-10-producing cells and normal IFN-gamma/IL-4 ratio. These data indicate that, in newly diagnosed and refractory patients with AAA, CD4+ cells are polarized towards a type-1 response that in turn leads to activation of cytotoxic CD8+ cells and finally to haemopoietic stem cell destruction. The type-1 response persists in patients in remission although this effect is compensated by the increase of IL-4 and IL-10 production.
authors.affiliation: Haematology Division, Department of Internal Medicine, University Hospital of Patras, Rion, Patras, Greece. ngiannakoulas@hotmail.com
authors.forename: Nikolaos C
authors.initials: NC
authors.lastname: Giannakoulas
authors.forename: Marina
authors.initials: M
authors.lastname: Karakantza
authors.forename: Georgios L
authors.initials: GL
authors.lastname: Theodorou
authors.forename: Maria
authors.initials: M
authors.lastname: Pagoni
authors.forename: Athanasios
authors.initials: A
authors.lastname: Galanopoulos
authors.forename: Theodora
authors.initials: T
authors.lastname: Kakagianni
authors.forename: Alexandra
authors.initials: A
authors.lastname: Kouraklis-Symeonidis
authors.forename: Panagiota
authors.initials: P
authors.lastname: Matsouka
authors.forename: Alice
authors.initials: A
authors.lastname: Maniatis
authors.forename: Nicholas C
authors.initials: NC
authors.lastname: Zoumbos
mesh_terms: D000328:Adult; D000368:Aged; D000741:Anemia, Aplastic / Q000276:immunology*; D003593:Cytoplasm / Q000276:immunology; D005260:Female; D006801:Humans; D016130:Immunophenotyping; D007371:Interferon-gamma / Q000378:metabolism*; D016753:Interleukin-10 / Q000378:metabolism; D007376:Interleukin-2 / Q000378:metabolism; D015847:Interleukin-4 / Q000378:metabolism; D007378:Interleukins / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D016176:T-Lymphocyte Subsets / Q000276:immunology; D018417:Th1 Cells / Q000276:immunology*; D018418:Th2 Cells / Q000276:immunology*
chemical_list: D007376:Interleukin-2; D007378:Interleukins; D016753:Interleukin-10; D015847:Interleukin-4; D007371:Interferon-gamma