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.
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Acknowledgments
We are grateful to the following scholars for their clinical and laboratory help: Prof. Zhenhua Tu, Prof. Chunyan Ji, Yuanyuan Zhu, Prof. Luqun Wang, Dr. Chuanli Zhao, and Dr. Qiang Song (Centre of Haematol/Oncology, Qilu Hospital, Shandong University, Jinan, China), and we are also grateful to Dr. Qianli Zhuang for critical review of this article. This work is supported by grants from National Natural Science Foundation of China (nos. 30300312, 30470742, 30579779, and 30600259), 973 Program 2006 CB 503803 and Key Clinical Research Project of Public Health Ministry of China 2004–2006.
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Guo, C., Chu, X., Shi, Y. et al. Correction of Th1-dominant Cytokine Profiles by High-dose Dexamethasone in Patients with Chronic Idiopathic Thrombocytopenic Purpura. J Clin Immunol 27, 557–562 (2007). https://doi.org/10.1007/s10875-007-9111-1
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DOI: https://doi.org/10.1007/s10875-007-9111-1