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International Journal of Medical Sciences

.: Home > International Journal of Medical Sciences > 2009 > Volume 6 Number 4 > Martin H. Bluth1, Stephan Kohlhoff 2,4, Kevin B. Norowitz2, Jonathan I Silverberg3,4, Seto Chice3, M Nowakowski3,4, Helen G. Durkin3,4, Tamar A. Smith-Norowitz 2,4

IMMUNE RESPONSES IN AUTOIMMUNE HEPATITIS: EFFECT OF PREDNISONE AND AZATHIOPRINE TREATMENT: CASE REPORT

Martin H. Bluth1, Stephan Kohlhoff 2,4, Kevin B. Norowitz2, Jonathan I Silverberg3,4, Seto Chice3, M Nowakowski3,4, Helen G. Durkin3,4, Tamar A. Smith-Norowitz 2,4
1. Deptartment of Pathology, Wayne State University School of Medicine, Detroit, MI 48201, USA; 2. Departments of Pediatrics, SUNY Downstate Medical Center, Brooklyn, New York 11203, USA; 3. Departments of Pathology, SUNY Downstate Medical Center, Brooklyn, New York 11203, USA; 4. Center for Allergy and Asthma Research, SUNY Downstate Medical Center, Brooklyn, New York 11203, USA.
Abstract :

The role of the immune response in autoimmune hepatitis has not been studied before and after prednisone and azathioprine treatment. Distributions of blood lymphocytes (CD4+, CD8+, CD19+, CD23+, CD16/56+), levels of serum immunoglobulins (IgM, IgG, IgE, IgA) and cytokines (IFN-م, IL-4, IL-12, TNFل ) were studied in a child (f/14 y/o) with autoimmune hepatitis before and after prednisone (20 mg/d) and azathioprine (50 mg/d) treatment (nephelometry, UniCAP Total IgE Fluoroenzymeimmunoassay, flow cytometry, cytokine ELISA). Patient was studied for 0-2.5 yrs; treatment was initiated 12 weeks post diagnosis. Numbers of CD4+ T cells increased (50%), while CD19+ and CD23+ cells decreased (>50%) post treatment; other lymphocyte subsets were unaffected by treatment. Serum IgG and IgE levels decreased (>50%) after treatment; serum IgM and IgA were within normal range and were not affected by treatment High levels of IFN-م (5-23 pg/ml) were initially detected in serum, which decreased after treatment (<0.1 pg/ml). Furthermore, low levels of IL-4 (0.2 pg/mL) were detected before treatment, which were not detected after treatment (<0.1 pg/ml). In contrast, before treatment, IL-12 and TNFل were not detected in serum; however after treatment the levels of IL-12 and TNFل dramatically increased. Prednisone and azathioprine treatment decreased total serum IgG, IgE, IFN-م and IL-4 levels, and blood
CD19+ and CD23+ cells; however serum IL-12, TNFل and blood CD4+ T cells increased with treatment. Understanding immunomodulation in autoimmune hepatitis will provide better insight and mechanisms of this disease and may tailor more effective therapeutic intervention.

Keywords :
autoimmune hepatitis, Immunoglobulin E (IgE), azathioprine treatment

Date Deposited : 27 Jul 2011 13:28

Last Modified : 27 Jul 2011 13:28

Official URL: http://www.medsci.org/archive

Volume 6, Number 4, - 2009 , ISSN 1449-1907

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