Nineteen patients aged > 60 years with chronic hepatitis C (CHC) received interferon (IFN) therapy and a complete response (CR) was achieved by five of them (26%). The incidence of CH with severe fibrosis in this elderly group was significantly higher than in another 52 patients with CHC who were < 60 years of age (the younger group; P < 0.05). There was no significant difference in the hepatitis C virus (HCV) genotype distribution between the elderly group and the younger group. However, the HCV-RNA titre was significantly higher in the elderly group than in the younger group (P < 0.05). There was no significant difference in the efficacy rate of IFN in the elderly and younger groups after standardization of the background factors. In the elderly group, the HCV-RNA titre was significantly lower in the patients achieving CR than in those with no response (P < 0.05). These data suggest that elderly patients with a low HCV-RNA titre can still respond well to IFN therapy.

We measured soluble interleukin 2 receptor, a part of the Tac protein (p55), in peripheral blood to study the immunological condition of the T cell in autoimmune thyroid disease. In 26 patients with untreated Graves' disease and 7 hyperthyroid patients with Hashimoto's thyroiditis, the mean levels of soluble IL-2 receptor were both significantly higher than in normal controls (1497\m=+-\649(mean \ m=+-\sd), 641\m=+-\137vs 221\m=+-\63103 U/l, p<0.001). There was good correlation between soluble IL-2 receptor levels and blood thyroxine levels (r=0.684, p<0.001) in patients with untreated Graves' disease, but no correlation of soluble IL-2 receptor with TSH-inhibitory immunoglobulins, TS-ab, thyroidal autoantibodies to thyroglobulin and thyroidal microsomal antigen was found. We thought that the level of soluble IL-2 receptor is not dependent only on immunological conditions, but also on thyroid hormone status. When T3 was administered to subjects in remission from Graves' disease and in normal controls, the soluble IL-2 receptor levels significantly increased. Moreover, the mean level of soluble IL-2 receptor in patients with toxic multinodular goitre was also significantly higher than in normal controls (411\m=+-\148 vs 221\m=+-\63 103U/l, p<0.05). We conclude that the soluble IL-2 receptor levels are higher in sera of subjects with elevated levels of thyroid hormone.Interleukin 2 (IL-2) receptor is expressed on the surface of activated T cells and is related to their proliferation by interaction with IL-2 (1,2). Soluble IL-2 receptor is released from the receptor ex¬ pressed on the surface of activated T cells (3). It is known that the levels of soluble IL-2 receptor are increased in the active stages of adult T cell leuke¬ mia and T cell malignancies (4), as well as in acute hepatitis and chronic active hepatitis (5). Moreover, soluble IL-2 receptor levels appear to reflect the clinical course (4,5).Graves' disease and Hashimoto's thyroiditis are both recognized as organ-specific autoimmune dis¬ eases. It has been reported that there are disorders of T cell subpopulations and functions, particularly in the thyroid gland of untreated Graves' disease (6,7). It has also been reported that during remis¬ sion these abnormalities improve and return almost to normal (6). Investigations of activated (Ia+) T cells and IL-2 receptor positive cells have been reported in autoimmune thyroid disease (8,9), in which activated (Ia+) T cells were signifi¬ cantly increased, whereas IL-2 receptor positive cells were not (10).We have previously reported that soluble IL-2 receptor levels were elevated in untreated Graves' disease (11). In order to investigate the participa¬ tion of activated T cells and to examine the useful¬ ness of soluble IL-2 receptor level as a marker of treatment, we measured soluble IL-2 receptor levels in various functional states of autoimmune thyroid disease. Subjects and MethodsWe studied 26 patients with untreated Graves' disease (20 females and 6 males; age 36±9 years, range 24-53). All patients were cl...

Alpha-interferon was used for anti-cancer or anti-viral therapy in two patients with pre existing autoimmune thyroid disease and in seven patients with chronic viral hepatitis who had no history of thyroid dysfunction. Primary hypothyroidism developed in the two patients who had a history of autoimmune thyroid disease, while no changes in thyroid function were observed in the other seven patients. Modulation of the immune system by alpha-interferon may have been responsible for the development of hypothyroidism in these two patients. Therefore, autoantibodies to the thyroid and the thyroid function should be assessed in patients undergoing alpha-interferon therapy.

A 57-year-old womanwas admitted with symmetrical proximal muscle weakness, liver dysfunction, abnormal muscle enzymes, and she was an antibody to hepatitis B e (anti-HBe) positive hepatitis B virus (HBV) carrier. Biopsy of her left quadriceps femoris showed myositis, so prednisolone was started at 40 mg/day. However,her hepatic function deteriorated and liver biopsy after 4 months showed acute hepatitis with partial submassive necrosis. Treatment with interferonalpha and cyclosporin A progressively reduced the transaminase and HBV-DNAlevels. Early treatment with interferon-alpha plus cyclosporin A can control exacerbation of hepatitis B.

Abstract.The effect of thyroid hormone on immune function is unclear. The influence of L-triiodothyronine on expression of the interleukin-2 receptor alpha chain by peripheral blood mononuclear cells from healthy volunteers and YT cells (an interleukin-2 independent natural killer-like cell line) was examined. Concanavalin A stimulation significantly (p<0.05 and p<0.01) increased soluble interleukin-2 receptor alpha chain production when mononuclear cells were cultured with triiodothyronine (1-100 nmol/1) for 3 days. The stimulatory effect of triiodothyronine on interleukin-2 receptor alpha chain expression was greater in the presence of concanavalin A (5 ,ug/ml) plus interleukin-2 (1 U/ml) than in the presence of concanavalin A alone. Triiodothyronine also significantly (p<0.01) increased interleukin-2 receptor alpha chain expression when YT cells were cultured for 2 days with interleukin-2 (1 U/ml), but did not influence receptor expression when YT cells were cultured with forskolin or 12-0-tetradecanoyl phorbol 13-acetate, potent activators of signal transduction.In conclusion, triiodothyronine may have an immunomodulatory effect by enhancing expression of the interleukin-2 receptor alpha chain on peripheral blood mononuclear cells in the presence of interleukin-2.