Journal of Clinical Immunology

, Volume 27, Issue 6, pp 557–562

Correction of Th1-dominant Cytokine Profiles by High-dose Dexamethasone in Patients with Chronic Idiopathic Thrombocytopenic Purpura

Authors

  • Chengshan Guo
    • Department of HematologySecond Hospital of Shandong University
  • Xiaoxia Chu
    • Department of HematologyYantai Yuhuangding Hospital
  • Yan Shi
    • Department of HematologyQilu Hospital, Shandong University
  • Weidong He
    • Shandong Blood Center
  • Lizhen Li
    • Department of HematologyQilu Hospital, Shandong University
  • Lin Wang
    • Department of HematologyQilu Hospital, Shandong University
  • Yingxue Wang
    • Department of HematologySecond Hospital of Shandong University
  • Jun Peng
    • Department of HematologyQilu Hospital, Shandong University
    • Department of HematologyQilu Hospital, Shandong University
Article

DOI: 10.1007/s10875-007-9111-1

Cite this article as:
Guo, C., Chu, X., Shi, Y. et al. J Clin Immunol (2007) 27: 557. doi:10.1007/s10875-007-9111-1

Abstract

To investigate the possible correcting of T helper (Th) cytokine profiles by high-dose dexamethasone (HD-DXM) therapy in chronic idiopathic thrombocytopenic purpura (ITP) with active disease, we determined the plasma levels of IFN-γ, IL-2, IL-4, IL-10, and TGF-β1 in 52 patients before and after oral administration of 40 mg/day DXM for four consecutive days. The cytokine levels were measured by enzyme-linked immunosorbent assay. The results showed that initial responses were reached in all patients and sustained response (SR) rate is 46.15%. The pretreatment plasma levels of both IFN-γ and IL-2 were significantly increased and those of IL-4, IL-10, and TGF-β1 significantly decreased, compared with those of the normal controls (P < 0.01), indicating a Th1-dominant cytokine profile typically found in ITP. After HD-DXM treatment, IFN-γ and IL-2 were decreased (P < 0.01), whereas IL-4 and IL-10 were increased (P < 0.05). There was no significant difference between the HD-DXM-treated patients and the normal controls (P > 0.05). TGF-β1 was also increased (P < 0.01) after HD-DXM treatment, but still lower than that of the normal controls (P < 0.05). During following-up, the cytokine profiles in the SRs remained stable compared to the posttreatment level (P > 0.05), but IFN-γ and IL-2 levels raised up, and IL-4, IL-10, and TGF-β1 levels reduced again in the relapsed patients (P < 0.01). Our data demonstrate that HD-DXM is an effective initial therapy for ITP, and the Th1 cytokine dominance could be corrected by HD-DXM.

Keywords

Idiopathic thrombocytophenic purpuracytokinesT helper lymphocytedexamethasone

Copyright information

© Springer Science+Business Media, LLC 2007