Abstract
Objectives: Studies of novel immunosuppressive agents using small numbers of healthy volunteers require validated methods for detecting pharmacodynamic effects. We investigated the ability of tuberculin-stimulated lymphocyte proliferation in whole blood and the tuberculin skin test to assess immunosuppression in healthy volunteers.
Methods: This was a parallel-group, placebo-controlled study. Five weeks after a tuberculin test, 14 study participants received either placebo or prednisolone (30mg or 60mg) once daily for 7 days. Blood samples were collected before the first dose and at 2 hours post-first dose for assessment of lymphocyte proliferation. On day 5, a repeat skin test was administered.
Results: Lymphocyte proliferation was reduced in all ten study participants who received prednisolone (mean reduction: 30mg=77.5%, 60mg=77%; p < 0.01 compared with placebo) with no reduction in any of the placebo group. While prednisolone reduced skin test size in seven study participants, there was an increase in three participants and no overall significant effect compared with placebo (p > 0.05).
Conclusion: Lymphocyte proliferation in whole blood was able to detect pharmacological immunosuppression in healthy individuals, while the tuberculin skin test did not. This whole blood method may have applications for detecting the effects of novel compounds in future healthy volunteer studies.
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References
Gibbs J, Ferguson J, Brown R, et al. Histometric study of the localisation of lymphocyte subsets and accessory cells in human Mantoux reactions. J Clin Pathol 1984; 37: 1227–34
Chu C, Field M, Andrew D, et al. Detection of cytokines at the site of tuberculin-induced delayed type hypersensitivity in man. Clin Exp Immunol 1992; 90: 522–9
Snyman J, Meyer E, Schoeman H. Cimetidine as modulator of the cell-mediated immune response in vivo using the tuberculin skin test as parameter. Br J Clin Pharmacol 1990; 29: 257–60
Dirks J, Van Aswegan C, Du Plessis D, et al. Effect of evening primrose oil on monocyte chemotactic protein-1 and tumour necrosis factor-alpha levels during delayed type hypersensitivity immune responses. Med Sci Res 1998; 26: 567–9
Yap J, Wang Y. The effect of ranitidine on the tuberculin skin test. Int J Tuberc Lung Dis 1998; 2: 344–7
Barnes PJ. Molecular mechanisms of corticosteroids in allergic diseases. Allergy 2001; 56: 928–36
De Groote D, Zangerle P, Gevaert Y, et al. Direct stimulation of cytokines (IL-1β, TNF-α, IFN-γ and GM-CSF) in whole blood: comparison with isolated PBMC stimulation. Cytokine 1992; 4: 239–48
Yaqoob P, Newsholme E, Calder P. Comparison of cytokine production in cultures of whole human blood and purified mononuclear cells. Cytokine 1999; 11: 600–5
Kasahara K, Strider R, Chensue S, et al. Mononuclear cell adherence induces neutrophil chemotactic factor (interleukin-8) gene expression. J Leukocyte Biol 1991; 50: 287–95
Bleeker M, Netea M, Kullberg B, et al. The effects of dexamethasone and chlorpromazine on tumour necrosis factor-alpha, interleukin-1β, interleukin-1 receptor antagonist and interleukin-10 in human volunteers. Immunology 1997; 91: 548–52
Chakraborty A, Blum R, Cutler D, et al. Pharmacoimmunodynamic interactions of interleukin-10 and prednisolone in healthy volunteers. Clin Pharmacol Ther 1999; 65: 304–18
Steer J, Vuong Q, Joyce D. Suppression of human monocyte tumour necrosis factor-α release by glucocorticoid therapy: relationship to systemic monocytopaenia and cortisol suppression. Br J Clin Pharmacol 1997; 43: 383–9
Stein M, Murray J, Wood A. Inhibition of stimulated interleukin-2 production in whole blood: a practical measure of cyclosporin effect. Clin Chem 1999; 45: 1477–84
Singh SD, Booth CG. Tuberculin-induced lymphocyte proliferation in whole blood: an antigen specific method for assessing immunosuppressive agents. J Immunol Methods 2002; 260: 149–56
Burastero S, Rossi G. Immunomodulation by interference with co-stimulatory molecules: therapeutic perspectives in asthma. Thorax 1999; 54: 554–7
Denton M, Magee C, Sayegh M. Immunosuppressive strategies in transplantation. Lancet 1999; 353: 1083–91
Seibert F, DuFour E. Comparison between the international standard tuberculins, PPD-S and old tuberculin. Am Rev Tuberc 1954; 69: 585–94
Gambertoglio J, Amend W, Benet L. Pharmacokinetics and bioavailability of prednisone and prednisolone in healthy volunteers and patients: a review. J Pharmacokinet Biopharm 1980; 8: 1–31
Menzies R. Interpretation of repeated tuberculin tests. Am J Respir Crit Care Med 1999; 159: 15–21
Singh D, Sutton C, Woodcock A. Repeat tuberculin testing in BCG-vaccinated subjects in the United Kingdom: the booster effect varies with the time of reading. Am J Respir Crit Care Med 2001; 164: 962–4
Bovornkitti S, Kangsadal P, Sathirapat P, et al. Reversion and reconversion rate of tuberculin skin reactions in correlation with the use of prednisolone. Dis Chest 1960; 38: 51–5
Sousa A, Lane S, Atkinson B, et al. The effects of prednisolone on the cutaneous tuberculin response in patients with corticosteroid-resistant bronchial asthma. J Allergy Clin Immunol 1996; 97: 698–706
Pountain G, Keogan M, Hazleman B, et al. Effects of single dose compared with three days prednisolone treatment of healthy volunteers: contrasting effects on circulating lymphocyte subsets. Clin Pathol 1993; 46: 1089–92
Acknowledgements
This study was funded entirely by AstraZeneca Pharmaceuticals. During the study, Dave Singh’s salary was paid by AstraZeneca, and George Booth is an employee of AstraZeneca.
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Singh, D., Woodcock, A. & Booth, G. Pharmacodynamic Measurements of Immunosuppression in Healthy Individuals. Int J Pharm Med 17, 131–136 (2003). https://doi.org/10.1097/00124363-200317030-00006
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DOI: https://doi.org/10.1097/00124363-200317030-00006