Predominant T helper 1 cells in patients with idiopathic portal hypertension

Background:The pathologic mechanism of idiopathic portal hypertension (IPH) is unknown. Because cytokines and the balance of T helper (h) 1 and Th2 CD 4(+) T cells have been reported to be important for regulating the immune r esponse, in the present study we investigated the role of cytokines and the distribution of cytokine-producing cells in IPH patients. Methods: Serum levels of tumor necrosis factor (TNF)-alpha, soluble TNF rec eptor-I, -II, interferon (IFN)-gamma and interleukin (IL)-4 were measured i n IPH patients, fatty liver patients, chronic hepatitis patients and contro l subjects. The percentages of Th0, Th1 and Th2 CD4(+) T cells were examine d in peripheral and spleen lymphocytes in IPH patients by intracellular sta ining. Results: Serum levels of TNF-alpha soluble TNF receptor-I, interferon-gamma and IL-4 of IPH patients were not increased in comparison with control sub jects. Only the mean value of soluble TNF receptor-II was significantly hig her than that of control subjects and fatty liver patients. The ratios of T h1 and Th2 in both peripheral and spleen lymphocytes pf IPH patients were s ignificantly increased compared with the ratios found in peripheral lymphoc ytes of control subjects. The increase in the ratios was due to a decrease in the percentage of Th2 CD4(+) T cells. Conclusions: These results suggest that the imbalance of Th1 and Th2 CD4(+) T cells and TNF may be associated with the pathogenesis of IPH. (C) 2000 B lackwell Science Asia Pty Ltd.