Th2 dominance in nasal mucosa in patients with Wegener’s granulomatosis

• Published in: Clinical and experimental immunology Vol. 125; no. 2; pp. 332 - 339
• Main Authors: Balding, C. E. J., Howie, A. J., Drake‐Lee, A. B., Savage, C. O. S.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Science Ltd 01-08-2001; Blackwell; Oxford University Press; Blackwell Science Inc
• Subjects: Adolescent; Adult; Aged; Biological and medical sciences; Biopsy; CD3 Complex - analysis; CD3 Complex - immunology; Cells, Cultured; cytokines; Cytokines - biosynthesis; Cytokines - genetics; Cytokines - immunology; Female; Granulomatosis with Polyangiitis - immunology; Granulomatosis with Polyangiitis - pathology; Humans; Immunity, Mucosal; Immunohistochemistry; kidney; Kidney - immunology; Kidney - pathology; Male; Medical sciences; Middle Aged; Myeloblastin; Nasal Mucosa - immunology; Nasal Mucosa - pathology; Rheumatic Disease/Vasculitis; RNA, Messenger - biosynthesis; Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis; Serine Endopeptidases - pharmacology; Th1 Cells - drug effects; Th1 Cells - immunology; Th2 Cells - drug effects; Th2 Cells - immunology; vasculitis; Human; Immunopathology; Allergy; Pathogenesis; Mucosa; Cytokine; Cardiovascular disease; Wegener granulomatosis; Cell subpopulation; Kidney; Vascular disease; Interleukin 4; Vasculitis; Interleukin 2; Biopsy; Nose; Systemic disease; Immune deviation; Th2 lymphocyte; Lymphocyte
• ISSN: 0009-9104; 1365-2249
• DOI: 10.1046/j.1365-2249.2001.125002332.x

Wegener's granulomatosis initially affects upper respiratory tract organs including the nasal mucosa in more than 90% of patients. The inflammation is typically granulomatous with associated vasculitis. T lymphocytes are usually a prominent component of the leucocyte infiltrate. Previous studies using peripheral blood T cells have implicated IFN‐γ rich Th1‐type responses. This study addressed the cytokine milieu in nasal mucosa from 10 patients with active Wegener's granulomatosis using immunohistochemistry. Increased levels of CD3+ T cells and eosinophils were present compared with normal and disease controls. There was increased expression of IL‐4, down‐regulation of IL‐2 and no detectable IFN‐γ. There was increased expression of the chemokine receptor CCR3 by infiltrating cells, consistent with an IL‐4 dominant, Th2‐biased response. In contrast, renal biopsy tissue from 10 patients with active Wegener's granulomatosis showed expression of IL‐2 and IL‐4. The Th2‐type environment within nasal mucosa, often the initial site of disease activity in Wegener's, is consistent with a local allergic response in these patients.