title: Immune phenotype in children with therapy-naïve remitted and relapsed Crohn's disease.
abstract: OBJECTIVE
  To characterize the prevalence of subpopulations of CD4+ cells along with that of major inhibitor or stimulator cell types in therapy-naïve childhood Crohn's disease (CD) and to test whether abnormalities of immune phenotype are normalized with the improvement of clinical signs and symptoms of disease.
  
  
  METHODS
  We enrolled 26 pediatric patients with CD. 14 therapy-naïve CD children; of those, 10 children remitted on conventional therapy and formed the remission group. We also tested another group of 12 children who relapsed with conventional therapy and were given infliximab; and 15 healthy children who served as controls. The prevalence of Th1 and Th2, naïve and memory, activated and regulatory T cells, along with the members of innate immunity such as natural killer (NK), NK-T, myeloid and plasmocytoid dendritic cells (DCs), monocytes and Toll-like receptor (TLR)-2 and TLR-4 expression were determined in peripheral blood samples.
  
  
  RESULTS
  Children with therapy-naïve CD and those in relapse showed a decrease in Th1 cell prevalence. Simultaneously, an increased prevalence of memory and activated lymphocytes along with that of DCs and monocytes was observed. In addition, the ratio of myeloid /plasmocytoid DCs and the prevalence of TLR-2 or TLR-4 positive DCs and monocytes were also higher in therapy-naïve CD than in controls. The majority of alterations diminished in remitted CD irrespective of whether remission was obtained by conventional or biological therapy.
  
  
  CONCLUSIONS
  The finding that immune phenotype is normalized in remission suggests a link between immune phenotype and disease activity in childhood CD. Our observations support the involvement of members of the adaptive and innate immune systems in childhood CD.
authors.affiliation: Research Group for Pediatrics and Nephrology, Semmelweis University and Hungarian Academy of Sciences, H-1083, Budapest, Hungary. cseharon@gmail.com
authors.forename: Aron
authors.initials: A
authors.lastname: Cseh
authors.forename: Barna
authors.initials: B
authors.lastname: Vasarhelyi
authors.forename: Kriszta
authors.initials: K
authors.lastname: Molnar
authors.forename: Balazs
authors.initials: B
authors.lastname: Szalay
authors.forename: Peter
authors.initials: P
authors.lastname: Svec
authors.forename: Andras
authors.initials: A
authors.lastname: Treszl
authors.forename: Antal
authors.initials: A
authors.lastname: Dezsofi
authors.forename: Peter-Laszlo
authors.initials: PL
authors.lastname: Lakatos
authors.forename: Andras
authors.initials: A
authors.lastname: Arato
authors.forename: Tivadar
authors.initials: T
authors.lastname: Tulassay
authors.forename: Gabor
authors.initials: G
authors.lastname: Veres
mesh_terms: D056704:Adaptive Immunity / Q000276:immunology; D000293:Adolescent; D002648:Child; D003424:Crohn Disease / Q000276:immunology* / Q000503:physiopathology / Q000517:prevention & control* / Q000628:therapy*; D005260:Female; D006801:Humans; D007113:Immunity, Innate / Q000276:immunology; D016130:Immunophenotyping; D008297:Male; D010641:Phenotype; D012008:Recurrence; D012074:Remission Induction; D018417:Th1 Cells / Q000378:metabolism; D055815:Young Adult