Document Detail

Correction of Th1-dominant cytokine profiles by high-dose dexamethasone in patients with chronic idiopathic thrombocytopenic purpura.
MedLine Citation:
PMID:  17619126     Owner:  NLM     Status:  MEDLINE    
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-gamma, IL-2, IL-4, IL-10, and TGF-beta1 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-gamma and IL-2 were significantly increased and those of IL-4, IL-10, and TGF-beta1 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-gamma 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-beta1 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-gamma and IL-2 levels raised up, and IL-4, IL-10, and TGF-beta1 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.
Chengshan Guo; Xiaoxia Chu; Yan Shi; Weidong He; Lizhen Li; Lin Wang; Yingxue Wang; Jun Peng; Ming Hou
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2007-07-06
Journal Detail:
Title:  Journal of clinical immunology     Volume:  27     ISSN:  0271-9142     ISO Abbreviation:  J. Clin. Immunol.     Publication Date:  2007 Nov 
Date Detail:
Created Date:  2007-11-13     Completed Date:  2008-02-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8102137     Medline TA:  J Clin Immunol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  557-62     Citation Subset:  IM    
Department of Hematology, Second Hospital of Shandong University, Jinan, China.
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MeSH Terms
Anti-Inflammatory Agents / administration & dosage,  pharmacology*
Chronic Disease
Cytokines / biosynthesis*
Dexamethasone / administration & dosage,  pharmacology*
Middle Aged
Purpura, Thrombocytopenic, Idiopathic / drug therapy*,  immunology,  metabolism
Th1 Cells / drug effects*,  immunology,  metabolism
Reg. No./Substance:
0/Anti-Inflammatory Agents; 0/Cytokines; 50-02-2/Dexamethasone

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