Serum levels of Thl/Th2 cytokines, angiogenic growth factors, and other prognostic factors in young adult patients with hemophagocytic syndrome.
Serum levels of T helper 1 (Th1)/T helper 2 (Th2) cytokines, angiogenic growth factors, and other prognostic factors were measured in 5 young adult patients with virus-associated hemophagocytic syndrome (HPS). Levels of 2 Th1 cytokines (interleukin [IL]-18 and tumor necrosis factor-alpha), 2 Th2 cytokines (IL-10 and IL-6), and 2 angiogenic growth factors (soluble intercellular adhesion molecule-1 and hepatocyte growth factor) were high in all of the patients examined, whereas those of Th1 cytokines such as IL-12 and macrophage inflammatory protein-1a were normal or low. Levels of IL-18 and IL-10 were highest in case 2, with a fatal outcome, and were lowest in case 4, with rapid recovery within 1 month. Although IFN-gamma levels were not elevated in 2 patients (cases 3 and 5), IL-18 levels were markedly high in both of these cases and the IL-6 level was highest in case 3. In contrast with the marked increase in the level of IL-10, the levels of IL-6, sIL-2R, and ferritin decreased rapidly and returned to normal within 2 months after therapy in case 3. The IL-18 level decreased somewhat, but remained elevated for 6 months, and the patient achieved a complete response within 11 months. Taken together, our findings suggest that both IL-18 and IL-10, but not IL-12, may play important roles in young adult patients with HPS via enhancing and suppressing Th1 immune responses, respectively.
Murohashi
Ikuo
I
Department of Medical Technology, Saitama Prefectural University, Saitama, Japan. murohashi-ikuo@spu.ac.jp
Yoshida
Katsuhiko
K
Ihara
Noriko
N
Wakao
Daisuke
D
Yagasaki
Fumiharu
F
Nakamura
Yuichi
Y
Kawai
Nobutaka
N
Matsuda
Akira
A
Jinnai
Itsuro
I
Bessho
Masami
M
D000328:Adult; D042501:Angiogenic Proteins / Q000097:blood*; D016207:Cytokines / Q000097:blood*; D005260:Female; D006133:Growth Substances / Q000097:blood; D006801:Humans; D007111:Immunity, Cellular; D016753:Interleukin-10 / Q000276:immunology; D020382:Interleukin-18 / Q000276:immunology; D051359:Lymphohistiocytosis, Hemophagocytic / Q000097:blood* / Q000276:immunology; D008297:Male; D011379:Prognosis; D018417:Th1 Cells; D018418:Th2 Cells
D042501:Angiogenic Proteins; D016207:Cytokines; D006133:Growth Substances; D020382:Interleukin-18; D016753:Interleukin-10