Document 0109
 DOCN  M9470109
 TI    Immunomodulation during treatment of polymyositis with plasmapheresis
       and immunosuppressive drugs.
 DT    9409
 AU    Dau PC; Department of Medicine, Evanston Hospital, IL 60201.
 SO    J Clin Apheresis. 1994;9(1):21-5. Unique Identifier : AIDSLINE
       MED/94253025
 AB    Immunologic studies were carried out in a patient with polymyositis
       (PM), who showed increasing muscle strength and decreasing serum
       creatine phosphokinase levels during 20 weeks of treatment with
       plasmapheresis in conjunction with prednisone and cyclophosphamide.
       After an initial rise, serum IgG declined with treatment. Natural killer
       (NK) lymphocytes were reduced by 74%, B cells by 95%, and T cells by
       38%. Spontaneous proliferation of peripheral blood mononuclear cells
       increased dramatically. Within the CD4+ T cell subset there was
       increasing maturation as shown by a rise in percent mature (CD29+) cells
       and reciprocal decline of immature (CD45RA+) cells. At the same time
       CD4+ T cells became increasingly activated as shown by HLA-DR
       expression. The percentage of CD8+ T cells increased strongly with
       treatment, and they showed increased activation and expression of the
       cytotoxic CD29+ and CD11b- phenotypes. CD8+ T cells exhibiting CD45RA or
       CD11b+ suppressor phenotypes were overall unchanged; however, on
       follow-up a proportion of CD8+ cells expressed the activated suppressor
       effector (CD11b-CD28-) phenotype. In addition to control of PM by the
       possible deletion of activated autoreactive B and T lymphocyte clones
       with cyclophosphamide, the activation and maturation of CD4+ T cells
       during treatment may have downregulated the autoreactive disease
       process, either through direct antiidiotypic suppression or by induction
       of the observed increase in cytotoxic and suppressor CD8+ T cells.
 DE    Adult  Antigens, CD45/ANALYSIS  Case Report  CD4-CD8 Ratio  Female
       Human  Immunosuppressive Agents/*THERAPEUTIC USE  Phosphocreatine/BLOOD
       *Plasmapheresis  Polymyositis/IMMUNOLOGY/*THERAPY  Support, Non-U.S.
       Gov't  T-Lymphocyte Subsets/IMMUNOLOGY  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).