Immune phenotype in children with therapy-naïve remitted and relapsed Crohn’s disease

Abstract

AIM To characterize the prevalence of subpopulations of CD4+ cells along with that of major inhibitor or stimulator cell types in therapy naive 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 naive CD children, of those, 10 children remitted on conventional therapy and formed the re mission group We also tested another group of 12 children who relapsed with conventional therapy and were given infliximab, and 15 healthy children who served as controls The prevalence of Th1 and Th2, naive 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 naive 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 TLR2 or TLR4 positive DCs and monocytes were also higher in therapy naive 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 (C) 2010 Baishideng All rights reserved