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Effect of cyclosporine on lymphocytic variant hypereosinophilic syndrome.

Abstract
Lymphocytic variant hypereosinophilic syndromes (L-HES) is thought to be caused by the over-production of interleukin (IL)-5 by type 2 helper cells, which leads to reactive eosinophil expansion and activation. Here we demonstrate the effect of cyclosporine in a patient with L-HES. In the present case, the surface markers of cells from resected lymph nodes or peripheral blood were analyzed by flow cytometry. Serum concentrations of IL-4, IL-5, and IL-8 were measured using an enzyme-linked immunosorbent assay. Methyl-prednisolone pulse therapy followed by the administration of 150 mg/day of cyclosporine combined with 15 mg/day of prednisolone ameliorated eosinophilia. However, abnormal CD3-CD4+ T cell clones remained even when the eosinophil count recovered to normal levels. An elevated IL-8 level was observed only when eosinophils increased. On the other hand, serum IL-4 and IL-5 levels were under detectable limits during the course. Cyclosporine was effective in decreasing the eosinophil count without the elimination of abnormal T cell clones in the present case. Cytotoxic agents may be necessary to cure this serious disease. Moreover, target therapy for IL-8 may be a new strategy for L-HES with high IL-8 and low IL-5 concentrations.
AuthorsRie Tabata, Chiharu Tabata, Yuki Katashima, Ryoji Yasumizu
JournalInternational immunopharmacology (Int Immunopharmacol) Vol. 16 Issue 4 Pg. 488-91 (Aug 2013) ISSN: 1878-1705 [Electronic] Netherlands
PMID23669338 (Publication Type: Case Reports, Journal Article)
CopyrightCopyright © 2013 Elsevier B.V. All rights reserved.
Chemical References
  • Immunosuppressive Agents
  • Interleukins
  • Cyclosporine
Topics
  • CD4 Lymphocyte Count
  • CD4-Positive T-Lymphocytes (drug effects, immunology)
  • Cyclosporine (administration & dosage, therapeutic use)
  • Eosinophils (cytology)
  • Flow Cytometry
  • Humans
  • Hypereosinophilic Syndrome (blood, diagnosis, drug therapy, immunology)
  • Immunosuppressive Agents (administration & dosage, therapeutic use)
  • Interleukins (blood)
  • Lymph Nodes (immunology)
  • Male
  • Middle Aged
  • Treatment Outcome

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