A case of Mikulicz's disease with Th2-biased cytokine profile: possible feature discriminable from Sjögren's syndrome.
This article concerns a male patient with Mikulicz's disease (MD) accompanied with marked elevation of serum immunoglobulin (Ig)G4 and IgE levels. His peripheral blood mononuclear cells (PBMC) showed markedly enhanced in vitro production of interleukin (IL)-4, IL-5, IL-13, but not interferon gamma (IFN-gamma) compared with patients with Sjögren's syndrome (SS) and healthy donors, suggesting distinct Th2 bias in this MD patient. Besides the prominent infiltration of IgG4-producing plasma cells, the enhanced expression of both CD40 and CD40 ligand (CD40L) were observed in the swollen salivary gland of the MD patient, suggesting enhanced signaling pathways for the induction of IgG4 and IgE switching. Possible differences between MD and SS in light of their underlying pathogenesis are discussed.
Kudo-Tanaka
Eriko
E
Department of Rheumatology, NHO Osaka-Minami Medical Center, 2-1 Kidohigashi-machi, Kawachinagano, Osaka, 586-8521, Japan. 04rher@ommc-hp.jp
Nakatsuka
Shinichi
S
Hirano
Toru
T
Kawai
Mari
M
Katada
Yoshinori
Y
Matsushita
Masato
M
Ohshima
Shiro
S
Ishii
Masaru
M
Miyatake
Kunio
K
Tanaka
Toshio
T
Saeki
Yukihiko
Y
D019013:CD40 Antigens / Q000276:immunology; D023201:CD40 Ligand / Q000276:immunology; D016207:Cytokines / Q000276:immunology*; D003937:Diagnosis, Differential; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood / Q000276:immunology; D007074:Immunoglobulin G / Q000097:blood / Q000276:immunology; D007963:Leukocytes, Mononuclear / Q000276:immunology; D008297:Male; D008875:Middle Aged; D008882:Mikulicz' Disease / Q000175:diagnosis* / Q000276:immunology; D012469:Salivary Glands / Q000276:immunology; D012859:Sjogren's Syndrome / Q000175:diagnosis* / Q000276:immunology; D018418:Th2 Cells / Q000276:immunology*
D019013:CD40 Antigens; D016207:Cytokines; D007074:Immunoglobulin G; D023201:CD40 Ligand; D007073:Immunoglobulin E