Brief Article
Copyright ©2010 Baishideng. All rights reserved
World J Gastroenterol. Mar 7, 2010; 16(9): 1104-1109
Published online Mar 7, 2010. doi: 10.3748/wjg.v16.i9.1104
New means to monitor the effect of glucocorticoid therapy in children
Hanne Rintamäki, Harri M Salo, Outi Vaarala, Kaija-Leena Kolho
Hanne Rintamäki, Kaija-Leena Kolho, Division of Gastroenterology, Hospital for Children and Adolescents, University of Helsinki, Helsinki, FIN-00029, Finland
Harri M Salo, Outi Vaarala, Immune Response Unit, Department of Vaccination and Immune Protection, National Institute for Health and Welfare, Helsinki, FIN-00300, Finland
Author contributions: Kolho KL and Vaarala O designed the research; Rintamäki H and Salo HM performed the research; Rintamäki H, Salo HM, Vaarala O and Kolho KL analyzed the data; Rintamäki H, Salo HM, Vaarala O and Kolho KL wrote the paper.
Supported by The Finnish Cultural Foundation, the Finnish Pediatric Research Foundation, the Päivikki and Sakari Sohlberg Foundation, and the Orion Research Foundation
Correspondence to: Kaija-Leena Kolho, MD, PhD, Division of Gastroenterology, Hospital for Children and Adolescents, University of Helsinki, Box 281, Helsinki, FIN-00029, Finland. kaija-leena.kolho@helsinki.fi
Telephone: +358-9-47174787 Fax: +358-9-47172599
Received: November 26, 2009
Revised: January 6, 2010
Accepted: January 13, 2010
Published online: March 7, 2010
Abstract

AIM: To study the individual effects of glucocorticoid (GC) therapy on the state of immune activation in patient serum.

METHODS: We developed a novel assay in which the effect of corticosteroid-treated patient serum on healthy donor peripheral blood mononuclear cells (target cells) was studied, with a panel of markers for effector [interferon (IFN)γ and interleukin (IL)-5] and regulatory T cells (FOXP3 and glucocorticoid-induced tumor necrosis factor receptor, GITR). The study group comprised 19 children with inflammatory bowel disease. The individual effect of patient serum on target cells was analyzed prior to GC therapy and 2 wk later.

RESULTS: The effect of GC therapy mediated by patient serum was seen as a decrease in the target cells expression of regulatory T-cell-related markers GITR (median suppression 24%, range of suppression 1%-63%, in 2 cases increase of 6% and 77%, P < 0.01 for mitogen-activated target cells) and FOXP3 (median suppression 33%, range of suppression 0%-79%, in one case an increase of 173%, P < 0.05 for resting cells), and secretion of IFNγ [from a mean of 87 700 pg/mL (SD 33 900 pg/mL) to 60 900 pg/mL (SD 44 200 pg/mL) in mitogen-activated target cells, 13 of the cases showed a decrease, P < 0.01]. The total or weight-related prednisolone dose did not correlate with the patient-serum-induced changes in the target cell markers.

CONCLUSION: GC response could be monitored at an individual level by studying the effect of patient serum on signaling pathways of target immune cells.

Keywords: Glucocorticoid-induced tumor necrosis factor receptor; FOXP3; Inflammatory bowel disease; Children