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Increased Allergen-Specific, Steroid-Sensitive γδ T Cells in Bronchoalveolar Lavage Fluid from Patients with Asthma

Fabrizio Spinozzi, MD; Elisabetta Agea, MD; Onelia Bistoni, BSc; Nicolino Forenza, MD; Alessandro Monaco, MD; Gabrio Bassotti, MD, PhD; Ildo Nicoletti, MD; Carlo Riccardi, MD; Fausto Grignani, MD; and Alberto Bertotto, MD
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From the University of Perugia, Perugia, Italy. Acknowledgments: The authors thank Ms. Judy Etherington for helpful suggestions in reviewing the English version of the manuscript. Grant Support: In part by MURST (Italian Ministry for University and Scientific Research). Requests for Reprints: Fabrizio Spinozzi, MD, Istituo Medicina Interna e Science Oncologiche, Universita di Perugia, Policlinico Monteluce, I-06100 Perugia, Italy. Current Author Addresses: Drs. Spinozzi, Agea, Nicoletti, and Grignani: Istituto di Medicina Interna e Scienze Oncologische, Universita di Perugia, Policlinico Monteluce, I-06100, Perugia, Italy.

Copyright ©2004 by the American College of Physicians

Ann Intern Med. 1996;124(2):223-228. doi:10.7326/0003-4819-124-2-199601150-00005
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Objective: To test the hypothesis that allergen-specific, steroid-sensitive γδ T lymphocytes are increased in bronchoalveolar lavage fluid of patients with asthma.

Design: Case series.

Setting: The outpatient allergy services at the University of Perugia, Perugia, Italy.

Patients: 12 untreated atopic patients (6 children and 6 adults) with mildly symptomatic chronic asthma were studied. Bronchoalveolar lavage fluid from 10 healthy nonsmoking volunteers and age-matched children with cystic fibrosis (n = 5) or anatomic malformation of the airways (n = 4) served as control samples.

Intervention: Three patients received treatment with deflazacort, 60 mg twice daily, for 1 week.

Measurements: CD3+, CD4+, and CD8+ T cells from patients and controls were examined by two-color flow cytometry for coexpression of Vδ1 and Vδ2 isoforms of the γδ T-cell receptor. In vitro pulmonary γδ T-cell proliferation in response to a specific allergen, the apoptotic death of these cells after incubation with 10−7 M dexamethasone, and bronchoalveolar lavage fluid T-lymphocyte composition before and after 1 week of deflazacort therapy were evaluated in 3 Dermatophagoides pteronyssinus-sensitive patients.

Results: The proportion of γδ T lymphocytes, primarily CD4+ or CD4 CD8 cells, was higher in asthmatic patients than in controls (P < 0.05 by one-way analysis of variance). Most lung γδ CD4+ lymphocytes expressed the γδ T-cell receptor Vδ1 chain. These cells proliferated in response to allergen stimulation, underwent steroid-induced apoptosis in vitro, and disappeared after systemic steroid treatment.

Conclusions: Allergen-specific, steroid-sensitive γδ T cells may be one of the cellular components involved in the airway inflammation that characterizes allergic bronchial asthma.


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Figure 1.
Effects of systemic steroid therapy on bronchoalveolar lavage fluid T-cell composition and γδ T-cell survival in allergic bronchial asthma.bottomtop

After 1 week of deflazacort treatment (60 mg twice daily), the absolute numbers of bronchoalveolar lavage CD3+ TCRδ1+ and CD4+ Vδ1+ T-cell values decreased abruptly ( ), whereas the global TCR-αβ+ T-cell compartment expanded, and did not increase again when therapy was discontinued ( ). The absolute bronchoalveolar lavage lymphocyte numbers remained stable in all samples tested. Data depicted are from a single patient of the three studied.

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