The analysis of eosinophil and lymphocyte phenotype following single dose of high-dose methylprednisolone in two siblings with marked hypereosinophilia

Abstract

The effect of single high-dose methylprednisolone (HDMP) on eosinophil and lymphocyte phenotype in two siblings with marked hypereosinophilia was investigated. Since conventional dose steroids failed to produce a haematological and clinical response in case one, both children were given HDMP (20 mg/kg/day). Eosinophils and lymphocytes showed an activated state before treatment, characterized by marked expression of CD11b, CD18, CD45RO on eosinophils and increased HLA-DR, CD95, CD18, CD38 on lymphocytes. Twenty-four hours after administration of HDMP a dramatic reduction in peripheral blood eosinophil count was observed in both patients associated with phenotypic changes characterized by decreased expression of CD11b, CD18, CD13 and increased CD95 expression in one. Furthermore, HDMP treatment induced a drop in the expression of CD95 and CD18 on lymphocytes. These changes may suggest a suppressive role for HDMP on eosinophil and lymphocyte activation which may have contributed to the haematological and clinical response.

Comparison of Megadose Methylprednisolone Versus Conventional Dose Prednisolone in Hematologic Disorders

“…98,99 Further effects of MDMP on the number and phenotype of eosinophils were shown in 2 siblings with hypereosinophilic syndrome, one of who was resistant to conventional doses of steroids. 100 …”

Primary Eosinophilic Lung Diseases and the Therapeutic Role of Corticosteroids: A Case Report and Literature Review

“…Another study compares the response of two siblings with hypereosinophilia to different doses of prednisolone where the sibling on a single High Dose Methylprednisolone (HDMP) showed significant AEC reduction in comparison to the sibling on conventional prednisolone. This suggests that HDMP alters the phenotype of eosinophils and reduces their activity (Uckan et al, 2001).…”

“…Eosinophils have been strongly implicated in the pathogenesis of the disease where a high number of eosinophils and its related cytokines like IL-3, IL-5, IL-6, IL-10 and Granulocyte-Macrophage Colony-Stimulating Factor (GM-CSF) were confined to the sections of infiltrated lung whilst sparing the serum and healthy lung tissues (Alam and Burki, 2007;Alberts, 2004). These cytokines, especially IL-5, activate the eosinophil, prevent apoptosis and stimulate degranulation (Fernandez Perez and Frankel, 2013; Alam and Burki, 2007;Uckan et al, 2001).…”

“…Glucocorticoids disrupt cytokine signalling between white cells, suppress colony formation and regulate cell surface receptors that receive regulatory molecules. These cumulatively reduce eosinophilic count, shorten cellular lifespan and prevent degranulation (Uckan et al, 2001;Brito-Babapulle, 2003). It has been reported that eosinophilic asthmatics show better control with inhaled corticosteroids than non-eosinophilic asthmatics (Martin et al, 2011).…”

Eosinophilia in a patient with cyclical vomiting: a case report

“…This protective mechanism appears to be specifically inhibiting eosinophil recruitment to the airway nerves [45]. Treatment with high dose methylprednisolone results in significant reduction in peripheral blood eosinophils and phenotypic changes characterized by decreased expression of CD11b, CD18, and CD13 which have an important role in the action of eosinophils [46]. In addition, glucocorticoids inhibit the cytokine-dependent survival of eosinophils [47].…”