The cytokine profile in a transient variant of angioedema with eosinophilia

Episodic angioedema with eosinophilia is characterized by recurrent angioed ema, fever and weight gain with a remarkable eosinophilia. A transient type , predominantly reported in Japan, in which the disease is limited to a sin gle attack, is usually less severe than the episodic type described in the U.S.A. and Europe, and provides an ideal disease model in which to study th e mechanisms for resolution of eosinophilic inflammation. The aim of this s tudy was to evaluate the relationship between cytokine responses and clinic al course in three patients with the transient type. Serum levels of interl eukin (IL) -5 were only marginally elevated even during an attack, unlike t hose in reported cases of the episodic type. Significant elevations in gran ulocyte-macrophage colony-stimulating factor levels were also noted during an attack in two cases in which it was measured. A dramatic increase in tum or necrosis factor (TNF) -alpha levels was subsequently observed in relatio n to resolution of clinical symptoms. No major changes in the serum levels of soluble Fas and soluble Fas ligand were found throughout the course. The se results suggest that relatively lower levels of IL-5 and a subsequent in crease in TNF-alpha levels are characteristic features of the transient typ e. The differences in clinical symptoms and course observed between the two types may be partly explained by the differences in the cytokine profiles.