T-HELPER TYPE-2 LIKE CYTOKINE RESPONSES TO PEPTIDES FROM P0 AND P2 MYELIN PROTEINS DURING THE RECOVERY PHASE OF GUILLAIN-BARRE-SYNDROME

T-lymphocytes are probably involved in the pathogenesis of Guillain-Ba rre syndrome (GBS). T-helper-1 (Th1) cytokines activate macrophages an d induce a delayed type hypersensitivity (DTH) inflammatory response, consistent with the morphology of the demyelination in CBS. Th2 cytoki nes encourage antibody production and downregulate Th1 responses. To s tudy the Th1/Th2 cytokines in relation to the clinical course of GBS a n ELISPOT method for determination of single cells secreting interfero n-gamma, IFN-gamma (Th1) or interleukin-4, IL-4 (Th2) was used. We ser ially investigated antigen-induced cytokine secretion from circulating T-cells stimulated with human peptides from the P0 and P2 proteins in seven patients and compared to results from seven serially investigat ed healthy controls. Most patients (five of seven) showed IL-4 respons es during the plateau- or recovery-phase as compared to controls. One patient with a prolonged disease course, on the other hand, had an IFN -gamma dominated reactivity. We suggest that the IL-4 responses are be neficial in GBS, and may have a role in terminating the disease proces s in this self-limiting inflammatory disease. (C) 1997 Elsevier Scienc e B.V.