Krampera M, Antico A, Vinante F, Morosato L, Pizzolo G
Department of Clinical and Experimental Medicine, University of Verona, Policlinico Borgo Roma, Italy.
Ann Allergy Asthma Immunol. 1999 Aug;83(2):144-8. doi: 10.1016/S1081-1206(10)62626-9.
Patients completely asymptomatic with extremely high levels of IgE have rarely been reported. One such case, in which the immunophenotype pattern of lymphocyte subsets and their cytokine profile were investigated, is described here.
To assess whether the cytokine production was consistent with a T helper 2-type immune response, as suggested by theories regarding the functional polarization of helper and cytotoxic T cells in hyper-IgE conditions.
An asymptomatic 79-year-old man presented with persistent high levels of serum IgE and sporadic hypereosinophilia without any evidence of an underlying pathologic condition. We investigated the immunophenotype of circulating lymphocytes, the expression/release of CD30 (a member of the tumor necrosis factor receptor family preferentially associated with T helper 2-type immune responses) and the intracellular patterns of interferon-gamma (IFN-gamma), Interleukin-2 (IL-2), IL-4, IL-5, and IL-10 production by T cell subsets, as evaluated by single-cell flow-cytometric analysis.
The majority of lymphocytes displayed the membrane immunophenotype of NK cells. Both CD4+ and CD8+ T cells were reduced and expressed the "memory" (CD4+/CD45RO+) and the "naive" (CD8+/CD45RA+) phenotypes, respectively. Among CD4+ T cells, CD30 expression was increased in the resting condition and was further inducible following stimulation with mitogenic anti-CD3. Interleukin-4, IL-2, and IL-10 production by CD4+ T cells was increased, whereas IFN-gamma was reduced as compared with normals.
The data suggest that a polarization of CD4+ T cells towards a T helper 0/2-type cytokine pattern occurred in this patient in spite of CD4+ cell reduction and NK cell expansion.
鲜有关于IgE水平极高但完全无症状患者的报道。本文描述了这样一例病例，并对其淋巴细胞亚群的免疫表型模式及其细胞因子谱进行了研究。
根据辅助性T细胞和细胞毒性T细胞在高IgE状态下功能极化的理论，评估细胞因子的产生是否与辅助性T细胞2型免疫反应一致。
一名79岁无症状男性，血清IgE持续高水平且偶发嗜酸性粒细胞增多，无任何潜在病理状况的证据。我们通过单细胞流式细胞术分析，研究了循环淋巴细胞的免疫表型、CD30（肿瘤坏死因子受体家族成员，优先与辅助性T细胞2型免疫反应相关）的表达/释放，以及T细胞亚群产生干扰素-γ（IFN-γ）、白细胞介素-2（IL-2）、IL-4、IL-5和IL-10的细胞内模式。
大多数淋巴细胞表现出自然杀伤细胞的膜免疫表型。CD4+和CD8+ T细胞均减少，分别表达“记忆”（CD4+/CD45RO+）和“幼稚”（CD8+/CD45RA+）表型。在CD4+ T细胞中，静止状态下CD30表达增加，用促有丝分裂抗CD3刺激后可进一步诱导表达。与正常人相比，CD4+ T细胞产生的白细胞介素-4、IL-2和IL-10增加，而IFN-γ减少。
数据表明，尽管该患者CD4+细胞减少且自然杀伤细胞扩增，但CD4+ T细胞仍向辅助性T细胞0/2型细胞因子模式极化。
