title: Changes in cytokine profile pre- and post-immunosuppression in acquired aplastic anemia.
abstract: Cytokine expression assessed by flow cytometry in 53 acquired aplastic anemia patients before and after combined immunosuppression (EBMT WPSAA protocols) showed that CD3(+) marrow cells containing TNF-alpha, IFN-gamma and IL4 were similar in subjects with disease at onset (DO) and responsive to treatment who had more CD3(+)/TNF-alpha(+) and CD 3(+)/IFN-gamma(+) cells than normal controls. In vitro block of TNF-alpha and/or IFN-gamma significantly increased BFU-e over baseline in 28 patients. In responsive to treatment patients only TNF-alpha block significantly incremented colonies over normal controls. Absolute marrow CD3(+)/TNF-alpha(+) and CD3(+)/IFN-gamma(+) cells prospectively tested in a group of 21 subjects declined significantly more in Responders than in Non Responders to immunosuppression at Response Evaluation Time respect to Diagnosis. Both in Responders and in Non Responders these cells remained higher than in normal controls. This study suggests that immunosuppression does not fully clear excess TNF-alpha and IFN-gamma from marrow of patients with good outcome and raises the hypothesis that additional cytokine blockade might be useful in immunosuppression for acquired aplastic anemia.
authors: Haematology Unit, G. Gaslini Children's Hospital, Genoa, Italy. carlodufour@ospedale-gaslini.ge.it
authors: Carlo
authors: C
authors: Dufour
authors: Elisa
authors: E
authors: Ferretti
authors: Francesca
authors: F
authors: Bagnasco
authors: Oriana
authors: O
authors: Burlando
authors: Marina
authors: M
authors: Lanciotti
authors: Ugo
authors: U
authors: Ramenghi
authors: Paola
authors: P
authors: Saracco
authors: Maria Teresa
authors: MT
authors: Van Lint
authors: Daniela
authors: D
authors: Longoni
authors: Giovanni Fernando
authors: GF
authors: Torelli
authors: Marta
authors: M
authors: Pillon
authors: Anna
authors: A
authors: Locasciulli
authors: Aldo
authors: A
authors: Misuraca
authors: Milena
authors: M
authors: La Spina
authors: Andrea
authors: A
authors: Bacigalupo
authors: Vito
authors: V
authors: Pistoia
authors: Anna
authors: A
authors: Corcione
authors: Johanna
authors: J
authors: Svahn
mesh_terms: D000293:Adolescent; D000328:Adult; D000741:Anemia, Aplastic / Q000378:metabolism* / Q000473:pathology; D001854:Bone Marrow Cells / Q000378:metabolism / Q000473:pathology; D017252:CD3 Complex / Q000378:metabolism; D049109:Cell Proliferation; D002478:Cells, Cultured; D002648:Child; D002675:Child, Preschool; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D007165:Immunosuppression Therapy / Q000379:methods*; D007371:Interferon-gamma / Q000378:metabolism*; D015847:Interleukin-4 / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism*; D055815:Young Adult
chemical_list: D017252:CD3 Complex; D014409:Tumor Necrosis Factor-alpha; D015847:Interleukin-4; D007371:Interferon-gamma