Increasing evidence suggests that cytokine dysregulation in T-helper 1 and T-helper 2 (Th1/Th2) subsets contributes to the pathogenesis of Crohn’s disease (CD). This pilot study examines the hypothesis that cytokine profiles differ between pediatric and adult CD patients. Production of Th1 cytokines interferon-gamma (IFN-γ) and tumor necrosis factor-alpha (TNF-α) and of Th2 cytokines interleukin-4 (IL-4) and interleukin-6 (IL-6) were analyzed in peripheral blood of patients with CD and healthy controls (n=20) using flow cytometry after in vitro stimulation. In both pediatric and adult subjects, frequencies of TNF-α CD4+ T cells were higher in CD patients than in controls (p=0.009, p=0.047, respectively). Percentages of cells expressing IL-4 were slightly increased (p=0.036) while those for IFN-γ were decreased (p=0.009) in pediatric CD patients compared with controls. As expected, the overall production of Th1 cytokines was higher in adults compared with pediatric subjects. When memory CD4+CD45RO+ T cells were considered, lower IFN-γ expression was observed in pediatric CD subjects compared with controls (p=0.009), matching the trend seen in the general CD4+ T cell population. The percentage of CD4+CD45RO+ T cells were increased in adult CD patients compared with pediatric CD patients (p=0.016). This study describes a peripheral blood Th1/Th2 cytokine imbalance in CD and suggests different immunological mechanisms between children and adults in disease pathogenesis.
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