Normal T-helper 1/T-helper 2 balance in peripheral blood of coeliac disease patients

Activated T cells, with their secretion of cytokines, probably play an impo rtant role in the pathogenesis of mucosal lesions in coeliac disease (CoD) and the prominence of a T-helper (Th)l-type cytokine pattern has been repor ted. As the process of immunological activation in the jejunal mucosa in ac tive Coo has been shown to also cause some differences in peripheral blood lymphocyte populations, we sought to establish any changes in the Th1/Th2 b alance in peripheral blood of patients, at different stages of Coo, relativ e to healthy individuals. Twenty-two Coo patients and 10 healthy controls w ere included in the study. The Th1/Th2 balance was examined both in resting cells and after polyclonal stimulation using two different methods: intrac ytoplasmic cytokine contents were measured using an intracellular staining method and three-colour flow cytometry and cytokine contents of cell cultur e supernatants were measured using traditional enzyme-linked immunosorbent assays (ELISAs). Interferon-gamma (IFN-gamma)-producing cells (Th1) were as prominent in untreated Coo patients and treated Coo patients as in healthy controls, while cells fitting a Th2 or Th0-type cytokine pattern were few in all groups. In ELISA assays, Th1 type (IFN-gamma or interleukin (LL)-2) cytokines were again prominent in all study groups but no statistically sig nificant differences were found in IFN-gamma, IL-4 or IL-2 levels among the three groups. These results suggest that the increased shift towards a Th1 response is mainly restricted to the actual site of inflammation and that circulating T cells do not show a similar response, presumably because acti vated cells in peripheral blood are too few. Further research on cytokine p rofiles measuring T-cell activation in Coo should be focused on the actual tissue of inflammation.