THE FREQUENCY OF CELLS SECRETING INTERFERON-GAMMA AND INTERLEUKIN-4, INTERLEUKIN-5, AND INTERLEUKIN-10 IN THE BLOOD AND DUODENAL MUCOSA OF CHILDREN WITH COWS MILK HYPERSENSITIVITY

Enzyme-linked immunoabsorbant spots (ELISPOTs) have been used to analy ze the frequency of cells spontaneously secreting interferon-gamma (IN F-gamma), IL-4, IL-5, or IL-10 in mononuclear cells isolated from the blood of children with cow's milk-sensitive enteropathy (CMSE), cow's milk allergy (CMA), and age-matched controls. In addition, cytokine pr ofiles of duodenal lamina propria lymphocytes were compared in patient s with CMSE and control subjects. In blood, spontaneous cytokine-secre ting cells were uncommon, but there was significantly increased IFN-ga mma, IL-4, IL-5, and IL-10 ELISPOTs in children with CMSE and CMA comp ared with control subjects. IL-4 ELISPOTs were significantly greater i n the blood of children with CMA compared with those with CMSE. In the lamina propria the frequencies of spontaneous cytokine-secreting cell s were high compared with that in blood. Significantly increased ELISP OTs for IFN-gamma and IL-4 were found in CMSE compared with controls. IL-5 ELISPOTs were unchanged, and IL-10 ELISPOTs were reduced in CMSE compared with controls. These results show a general enhancement of Th -1 and Th-2-type cytokine-secreting cells in the blood of children wit h cow's milk hypersensitivity, although the increased IL-4-secreting c ells in blood in CMA may be of relevance in view of the fact that this disease is IgE-mediated. In the lamina propria, there is also enhance ment of IFN-gamma- and IL-4-secreting cells in CMSE compared with cont rol subjects; however, cells secreting IFN-gamma are 10 times more num erous than cells secreting IL-4, showing a dominance of Th-1-type resp onses in both controls and CMSE patients.