Correction of Th1-dominant Cytokine Profiles by High-dose Dexamethasone in Patients with Chronic Idiopathic

To investigate the possible correcting of T helper (Th) cytokine profiles by high-dose dexamethasone (HD- DXM) therapy in chronic idiopathic thrombocytopenic purpura (ITP) with active disease, we determined the plasma levels of IFN-γ, IL-2, IL-4, IL-10, and TGF-β 1i n 52 patients before and after oral administration of 40 mg/ day DXM for four consecutive days. The cytokine levels were measured by enzyme-linked immunosorbent assay. The results showed that initial responses were reached in all patients and sustained response (SR) rate is 46.15%. The pretreatment plasma levels of both IFN-γ and IL-2 were significantly increased and those of IL-4, IL-10, and TGF- β1 significantly decreased, compared with those of the normal controls (P 0.05). TGF-β1 was also increased (P 0.05), but IFN-γ and IL-2 levels raised up, and IL-4, IL-10, and TGF- β1 levels reduced again in the relapsed patients (P<0.01). Our data demonstrate that HD-DXM is an effective initial therapy for ITP, and the Th1 cytokine dominance could be corrected by HD-DXM.