SUMMARY
Background: Recent studies have shown both interleukin 2 (IL‐2) and interferon gamma (IFN) to be elevated in patients with active Crohn's disease compared to ulcerative colitis or non‐inflammatory bowel disease controls. However the effect of treatment on these lymphokines has not been studied.
Patients and methods: Using a reverse haemolytic plaque assay the percentage of lymphokine‐secreting cells was determined in the intestinal mucosa of children with Crohn's disease before and after 8 weeks of treatment with either enteral nutrition, cyclosporin or steroids.
Results: Before treatment, a high percentage of cells isolated from mucosal biopsies secreted IL‐2 or interferon‐gamma. Eight weeks’treatment with the immunosuppressive agents cyclosporin, or with corticosteroids, produced a significant reduction in the percentage of IL‐2 secreting cells, although only for the former was there also a reduction in interferon‐gamma secreting cells. Enteral nutrition however, produced a reduction in lymphokine‐secreting cells equivalent to cyclosporin and produced the best histological and clinical improvement.
Conclusion: Enteral nutrition and cyclosporin can down‐regulate lymphokine secretion in the gut in Crohn's disease.
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