title: A pilot study on the changes in immunity after ACTH therapy in patients with West syndrome.
abstract: Adrenocorticotropic hormone (ACTH) has been the first-line drug for the treatment of West syndrome, although the therapy has various adverse effects. ACTH depresses resistance to a variety of bacterial, viral, protozoal, and fungal agents. The timing of the various vaccinations is delayed after ACTH therapy in Japan, because the immune system is believed to be affected for approximately 6 months. However, the duration of the effect of ACTH on the immune system is not known. Therefore, we examined changes in the immunity levels before and after ACTH therapy. We measured white blood cell counts, lymphocyte counts, T/B cell counts, CD4(+) and CD8(+) T cell counts, CD 4/8 ratio, lymphocyte blastoid transformation by PHA or Con-A, and the levels of IgA, IgM, and IgG before, immediately after, and 1, 3, 6, and 12 months after ACTH therapy. The lymphocyte counts and CD4(+) T cell counts were significantly decreased immediately after and at 1 and 3 months after the therapy, and did not return to the previous levels even at 6 months and 12 months after ACTH treatment; however, these levels returned to within normal limits (within the 95% confidence interval). Immunoglobulin levels did not change after the ACTH therapy. Helper T cells were more depressed than cytotoxic T cells after ACTH therapy.
authors.affiliation: Department of Pediatrics and Child Health, Kurume University School of Medicine, 67 Asahi-machi, Kurume 830-0011, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Ohya
authors.forename: Toshisaburo
authors.initials: T
authors.lastname: Nagai
authors.forename: Yuko
authors.initials: Y
authors.lastname: Araki
authors.forename: Takashi
authors.initials: T
authors.lastname: Yanagawa
authors.forename: Takuya
authors.initials: T
authors.lastname: Tanabe
authors.forename: Kuniaki
authors.initials: K
authors.lastname: Iyoda
authors.forename: Mana
authors.initials: M
authors.lastname: Kurihara
authors.forename: Kazuya
authors.initials: K
authors.lastname: Yamamoto
authors.forename: Kenji
authors.initials: K
authors.lastname: Masunaga
authors.forename: Chiho
authors.initials: C
authors.lastname: Iizuka
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Nagamitsu
authors.forename: Yushiro
authors.initials: Y
authors.lastname: Yamashita
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Awaya
authors.forename: Kihei
authors.initials: K
authors.lastname: Maekawa
authors.forename: Toyojiro
authors.initials: T
authors.lastname: Matsuishi
mesh_terms: D000324:Adrenocorticotropic Hormone / Q000276:immunology* / Q000627:therapeutic use*; D001402:B-Lymphocytes / Q000187:drug effects / Q000276:immunology; D001772:Blood Cell Count; D015496:CD4-Positive T-Lymphocytes / Q000187:drug effects / Q000276:immunology; D018414:CD8-Positive T-Lymphocytes / Q000187:drug effects / Q000276:immunology; D005260:Female; D006801:Humans; D007109:Immunity / Q000187:drug effects / Q000276:immunology; D007132:Immunoglobulin Isotypes / Q000097:blood / Q000187:drug effects*; D007223:Infant; D008213:Lymphocyte Activation / Q000187:drug effects / Q000276:immunology; D008297:Male; D010865:Pilot Projects; D013036:Spasms, Infantile / Q000097:blood / Q000188:drug therapy / Q000276:immunology*; D013601:T-Lymphocytes / Q000187:drug effects / Q000276:immunology; D013997:Time Factors
chemical_list: D007132:Immunoglobulin Isotypes; D000324:Adrenocorticotropic Hormone