Background The cause of persistent eosinophilia and the hypereosinophilicsyndrome is unknown. Recent work suggests that in some patientswith the hypereosinophilic syndrome, a clone of abnormal T cellsproduces large amounts of interleukin-5, a cytokine requiredfor the growth and differentiation of eosinophils. We examinedT-cell surface markers, rearranged T-cellreceptor genes,and in vitro production of cytokines by T cells from patientswith idiopathic eosinophilia.
Methods The expression of surface molecules on T cells was measuredby flow cytometry. Cytokine expression was measured by enzyme-linkedimmunosorbent assay, flow cytometry, and immunohistochemicalanalysis. To identify dominant (clonal) rearrangements of theT-cell receptor within the lymphocyte population, Southern blotanalysis (ß chain) and the polymerase chain reaction( chain) were performed according to standard protocols.
Results Among 60 patients with idiopathic eosinophilia, 16 hadcirculating T cells with an aberrant immunophenotype. In eachof these patients, the abnormal immunophenotype was unique.Evidence of clonal rearrangements of the T-cell receptor wasobtained in 8 of the 16 patients. In most instances, the abnormalT cells expressed large amounts of surface proteins associatedwith T-cell activation (the chain of the interleukin-2 receptorand the HLA-DR antigen). Moreover, the aberrant T cells producedlarge amounts of interleukin-5 in vitro.
Conclusions Clonal populations of abnormal T cells producinginterleukin-5 occur in some patients with idiopathic eosinophilia.
Source Information
From the Swiss Institute of Allergy and Asthma Research, University of Zurich, Davos, Switzerland (H.-U.S., K.B.); the Research Center for Environment and Health, Technical University of Munich, Munich, Germany (S.G.P.); and the Department of Dermatology, University of Zurich, Zurich, Switzerland (R.D.).
Address reprint requests to Dr. Simon at the Swiss Institute of Allergy and Asthma Research, University of Zurich, Obere Strasse 22, CH-7270 Davos, Switzerland, or at hus{at}siaf.unizh.ch.
Idiopathic Eosinophilia
Guitart J., Roufosse F., Schandené L., Cogan E., Suzuki R., Seto M., Nakaura S., Simon H.-U., Dummer R.
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N Engl J Med 2000;
342:659-661, Mar 2, 2000.
Correspondence
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