title: Frequent abnormalities of the immune system in gliomas and correlation with the WHO grading system of malignancy.
abstract: OBJECTIVE
  To investigate the cellular and humoral immunity status of gliomas, and their association with the WHO grading system.
  
  
  METHODS
  We have conducted a case-control study of 49 patients with gliomas and 30 healthy controls. We used ELISA assays, radial immunodiffusion, indirect immunofluorescence, latex test and flow cytometry assays to estimate preoperative in serum the immunological profile.
  
  
  RESULTS
  Patients with glioma had significantly reduced amounts of IL2 (p=0.000), TNF-a (p=0.033), IgG (p=0.011), IgA (p=0.027),C4 (p=0.026) ,CD3+ (p=0.001), CD4+ (p=0.000), CD8+ (p=0.002), ratio CD4/CD8 (p=0.000), CD19+ (p=0.04) and elevated IL10 (p=0.05) compared with healthy controls. No statistically significant differences were observed concerning viral agents, total NK cells, IgM, IgE, IL16, granzyme-b, RF, ANA, ENA, anti-dsDNA and anti-cardiolipin antibodies. A higher WHO grade, after controlling for age and gender, was associated with decreased number of CD3+ (p=0.011), CD4+ (p=0.015), CD8+ (p=0.048) and ratio CD4/CD8 (p=0.027), as well as with decreased IL2 (p=0.018), C4 (p=0.02), and IgG (p=0.05). IL2 and CD4+ counts were significant predictors of grade.
  
  
  CONCLUSIONS
  A shift from Th1 to Th2, a CD3+ and CD19+ lymphocytopenia, a diminished fraction CD4/CD8 and a reduced amount of immunoglobulins and complement were observed in the patients with gliomas. A higher WHO grade of the tumor was associated with greater impairments of immunity. Since defects of both humoral and cellular immunity were equally observed and significant predictors of grade were assessed, a preoperative evaluation of the immune system of patients with gliomas is being proposed.
authors.affiliation: Department of Neurosurgery,University Hospital of Ioannina, Greece. kostasgousias@yahoo.com
authors.forename: K
authors.initials: K
authors.lastname: Gousias
authors.forename: M
authors.initials: M
authors.lastname: Markou
authors.forename: V
authors.initials: V
authors.lastname: Arzoglou
authors.forename: S
authors.initials: S
authors.lastname: Voulgaris
authors.forename: G
authors.initials: G
authors.lastname: Vartholomatos
authors.forename: A
authors.initials: A
authors.lastname: Kostoula
authors.forename: P
authors.initials: P
authors.lastname: Voulgari
authors.forename: K
authors.initials: K
authors.lastname: Polyzoidis
authors.forename: A P
authors.initials: AP
authors.lastname: Kyritsis
mesh_terms: D000328:Adult; D000368:Aged; D015703:Antigens, CD / Q000097:blood / Q000276:immunology; D016022:Case-Control Studies; D016207:Cytokines / Q000097:blood; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods; D005260:Female; D005434:Flow Cytometry; D005910:Glioma / Q000145:classification / Q000150:complications* / Q000175:diagnosis / Q000276:immunology*; D006801:Humans; D007154:Immune System Diseases / Q000209:etiology* / Q000378:metabolism; D016015:Logistic Models; D018655:Lymphocyte Count; D008297:Male; D008875:Middle Aged; D009423:Nervous System Neoplasms / Q000145:classification / Q000150:complications* / Q000175:diagnosis / Q000276:immunology*; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D014944:World Health Organization
chemical_list: D015703:Antigens, CD; D016207:Cytokines