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Immune phenotype in children with therapy-nave remitted and relapsed Crohn’s disease

World Journal of Gastroenterology 2010年第47期16卷 6001-6009页

作者： aron cseh Barna Vasarhelyi Kriszta Molnar Balazs Szalay Peter Svec Andras Treszl Antal Dezsofi Peter Laszlo Lakatos Andras Arato Tivadar Tulassay Gabor Veres Research Group for Pediatrics and Nephrology Semmelweis University Hungarian Academy of Sciences Department of Laboratory Medicine Semmelweis University First Department of Pediatrics Semmelweis University First Department of Medicine Semmelweis University

AIM: To characterize the prevalence of subpopulations of CD4+ cells along with that of major inhibitor or stimulator cell types in therapy-nave childhood Crohn's disease (CD) and to test whether abnormalities of immune phenotype are normalized with the improvement of clinical signs and symptoms of disease. METHODS: We enrolled 26 pediatric patients with CD. 14 therapy-nave CD children; of those, 10 children remitted on conventional therapy and formed the remission group. We also tested another group of 12 chil-dren who relapsed with conventional therapy and were given infliximab; and 15 healthy children who served as controls. The prevalence of Th1 and Th2, nave and memory, activated and regulatory T cells, along with the members of innate immunity such as natural killer (NK), NK-T, myeloid and plasmocytoid dendritic cells (DCs), monocytes and Toll-like receptor (TLR)-2 and TLR-4 expression were determined in peripheral blood samples. RESULTS: Children with therapy-nave CD and those in relapse showed a decrease in Th1 cell prevalence. Simultaneously, an increased prevalence of memory and activated lymphocytes along with that of DCs and monocytes was observed. In addition, the ratio of myeloid /plasmocytoid DCs and the prevalence of TLR-2 or TLR-4 positive DCs and monocytes were also higher in therapy-nave CD than in controls. The majority of alterations diminished in remitted CD irrespective of whether remission was obtained by conventional or biological therapy. CONCLUSION: The finding that immune phenotype is normalized in remission suggests a link between immune phenotype and disease activity in childhood CD. Our observations support the involvement of members of the adaptive and innate immune systems in childhood CD.

关键词： Crohn’s disease Dendritic cell Infliximab Lymphocyte Monocyte Regulatory T cell Relapse Remission Therapy-nave Toll-like receptor

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