A pilot study on the changes in immunity after ACTH therapy in patients with West syndrome.
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.
Ohya
Takashi
T
Department of Pediatrics and Child Health, Kurume University School of Medicine, 67 Asahi-machi, Kurume 830-0011, Japan.
Nagai
Toshisaburo
T
Araki
Yuko
Y
Yanagawa
Takashi
T
Tanabe
Takuya
T
Iyoda
Kuniaki
K
Kurihara
Mana
M
Yamamoto
Kazuya
K
Masunaga
Kenji
K
Iizuka
Chiho
C
Nagamitsu
Shinichiro
S
Yamashita
Yushiro
Y
Awaya
Yutaka
Y
Maekawa
Kihei
K
Matsuishi
Toyojiro
T
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
D007132:Immunoglobulin Isotypes; D000324:Adrenocorticotropic Hormone