Combined cyclosporin-A /prednisone therapy of patients with active uveitis suppresses IFN-gamma production and the function of dendritic cells

Clin Exp Immunol. 2003 Aug;133(2):233-9. doi: 10.1046/j.1365-2249.2003.02214.x.

Abstract

In this study, we assessed the Th1/Th2 polarization of the immune response and the involvement of dendritic cells (DC) and Th1 lymphocytes in the pathogenesis of uveitis. Thirty-seven patients with chronic idiopathic uveitis were enrolled: 21 of them had active uveitis and the remaining 16 were in complete remission. Patients with active uveitis were characterized as follows: 5 had intermediate uveitis, 5 panuveitis and the remaining 11 posterior uveitis. Thirteen healthy subjects were also studied as controls. Patients with active uveitis were treated with cyclosporin-A (CsA) associated to low doses of prednisone (PDS) and studied at baseline and after 6 months of therapy. Analysis of cytokine-producing CD3+ lymphocytes revealed a strong Th1 polarization of the immune response in patients with active uveitis. Th1 lymphocytes paralleled serum IL-12 levels and the response to therapy, which greatly reduced both IFN-gamma+/CD3+ lymphocytes and serum IL-12 levels, associated with a general clinical improvement. In vitro studies demonstrated that DC from untreated patients with active uveitis were mature and functionally active. In fact, they showed a higher ability to stimulate cell proliferation of allogeneic T cells in primary mixed lymphocyte reaction (MLR) and produced larger amounts of IL-12 than DC from CsA/PDS-treated patients and those in remission. These results demonstrate that CsA/PDS therapy impairs the capacity of mature DC to secrete IL-12 and inhibits their MLR activity.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Chronic Disease
  • Cyclosporine / therapeutic use*
  • Dendritic Cells / drug effects*
  • Dendritic Cells / immunology
  • Drug Therapy, Combination
  • Female
  • Follow-Up Studies
  • Glucocorticoids / therapeutic use
  • Humans
  • Immunophenotyping
  • Immunosuppressive Agents / therapeutic use
  • Interferon-gamma / biosynthesis*
  • Interleukin-10 / blood
  • Interleukin-12 / blood
  • Lymphocyte Culture Test, Mixed
  • Male
  • Middle Aged
  • Prednisone / therapeutic use*
  • Th1 Cells / immunology
  • Uveitis / drug therapy*
  • Uveitis / immunology

Substances

  • Glucocorticoids
  • Immunosuppressive Agents
  • Interleukin-10
  • Interleukin-12
  • Interferon-gamma
  • Cyclosporine
  • Prednisone