1 Internal Medicine Department, Faculty of Medicine, Ain Shams University. 2 Biochemistry Department, Faculty of Science, Ain Shams University. 3 Clinical ...
Modulation of Immune Response In Asthmatic Patients By Using Inhaled Tuberculin Elsaiid M. Abou Gamrah1, Ibrahim H. Borai2, Omayma A. Lotfy3, Walid E. Zahran2*, Ingie B. Labib2 1
Internal Medicine Department, Faculty of Medicine, Ain Shams University 2
Biochemistry Department, Faculty of Science, Ain Shams University 3
Clinical Pathology Department, Ain Shams Specialized Hospital
Abstract Bronchial asthma is a chronic immuno inflammatory reversible lung disease with airway responsiveness to various stimuli which relived by proper therapy using inhaled steroids or the highly expensive recombinant interferon gamma (IFN-). This study undertaken to investigate for the first time a novel treatment method using inhaled tuberculin (PPD) to determine whether PPD inhalation could be safely and effectively delivered into the airways of bronchial asthmatic patients in attempt to bring immune deviation away from atopy via inhaling an economic dose of tuberculin. Sixty patients suffering from mild atopic bronchial asthma along with twenty healthy volunteers were included in our study. Patients were randomly categorized into three equally-sized groups received 2, 5 and 10 PPD units respectively. Treatment doses taken every 72 hours for two weeks. Respiratory function tests were examined before and after treatment regime. Interleukin 2 (IL-2), IL-4 and immunoglobulin E (IgE) were measured by ELISA technique in serum and bronchoalveolar lavage fluid (BALF) samples before and after treatment regime. Eosinophil count in BALF was also examined. The results showed that PPD treatment doses caused a significant increase in lung function standards (FEV1 and FEV1/FVC ratio) as compared with before treatment values. Also, the different doses of PPD resulted in a highly significant increase in the levels of serum and BALF IL-2 with a concomitant significant decrease in BALF IL-4 levels when compared with before treatment values. A highly significant decrease in serum and BALF IgE along with eosinophil count was obtained with PPD inhaled doses as compared with before treatment values. To conclude, PPD treatment could be safely, economically and effectively used as a potential therapeutic drug for patients with atopic bronchial asthma. A marked improvement in our laboratory results was observed with 5 and 10 units of PPD.
Keywords: Asthma, T Helper Cells, Tuberculin, Interleukins, IgE
Egyptian Journal of Biochemistry and Molecular Biology Vol. 26 (2). 135-152. 2008.