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Lymphokine overproduction in severe aplastic anemia is not related to blood
transfusions
W Hinterberger, G Adolf, P Bettelheim, K Geissler, C Huber, E Irschick, P Kalhs, U Koller, K Lechner and B Meister
1st Department of Medicine, University of Vienna, Austria.
The production of interferons (IFNs), IFN-gamma, tumor necrosis factors
(TNFs) and TNF-alpha (TNF-alpha) by peripheral blood mononuclear cells
(PBMNCs) of untransfused and transfused, but otherwise untreated patients
with severe aplastic anemia (SAA) was determined using bioassays and
immunoassays. In untransfused and pretransfused SAA patients, spontaneous
and lectin-induced production of these cytokines by PBMNCs was strongly
enhanced. Cytokine production in untransfused SAA patients did not differ
from that in pretransfused patients. Similar relative frequencies of
activated (HLA-DR+) lymphocyte subpopulations present in the PBMNCs
demonstrated cytokine overproduction per cells. Cytokine production was
studied in three SAA patients before and after blood cell transfusions.
Spontaneous and lectin-induced production of these cytokines was abnormally
high and unaffected by blood transfusions. In another patient exhibiting
abnormal cytokine production, the hematopoietic response to cyclosporin- A
in vivo was accompanied by normalization of cytokine production in vitro.
We conclude that overproduction of IFN-gamma and TNF-alpha by
lectin-stimulated PBMNCs is an intrinsic abnormality of SAA unrelated to
blood transfusions. Normalization of production of IFN-gamma and TNF- alpha
accompanying a clinical response to cyclosporin-A may cautiously be taken
as further evidence suggesting a pathogenetic role of cytokine
overproduction in SAA.
Volume 74,
Issue 8,
pp. 2713-2717,
12/01/1989
Copyright © 1989 by The American Society of Hematology
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