Elevated serum levels of interleukin-5 in patients with the syndrome of episodic angioedema and eosinophilia

Abstract

The syndrome of episodic angioedema and eosinophilia is characterized by cyclic edema, marked peripheral blood eosinophilia, and eosinophil degranulation in the dermis. Using a sensitive immunoenzymetric method, we measured serum interleukin (IL)-5 levels in four patients with this syndrome. We also determined the percentage of activated T cells in the peripheral blood of a new patient before and during an attack. In the patient presented, IL-5 levels peaked several days before maximal eosinophilia and then declined. This patient's lymphocytes showed an increased percentage, 28% (normal 2% to 3%), of activated T cells staining for both CD3 and HLA-DR 10 days before maximal eosinophilia, but no increase at the time of peak eosinophilia. In serum from three previously reported cases, elevated serum IL-5 levels were found during attacks. After glucocorticoid administration, IL-5 levels became undetectable in three of the four patients. Production of IL-5 is likely an important determinant of the pathophysiology of this syndrome.

Priming of eosinophil and neutrophil migratory responses by interleukin 3 and interleukin 5

“…On the other hand, the higher sensitivity of eosinophils to IL-5-induced priming of migratory responses might in most instances make the effect of IL-5 selective for eosinophils. In previous studies the concentration of IL-5 has been measured in plasma from asthmatic patients (7), patients with episodic angioedema and eosinophilia (22), and cancer patients treated with interleukin 2 (31), and in all cases the concentrations of IL-5 were in the picomolar range. Studies on receptors for IL-5 have revealed the presence of high-affinity receptors on eosinophils but not on neutrophils (6,17,21).…”

Increased interleukin‐6 production during the acute phase of the syndrome of episodic angioedema and hypereosinophilia

“…Positive HLADR and CD4 T cells, with elevated 494 I. level of soluble IL-2R have been previously described during acute attacks [4]. In addition, an increased percentage of activated T cells and of IL-5 level in the serum was detected some days before maximal eosinophilia [5], and probably take part in the eosinophil proliferation and chemotaxis. Among cytokines, the pro-inflammatory effects of IL-6 could explained some local and systemic events occurring during acute attacks in this syndrom.…”

“…More recently, the role of Tlymphocytes was also underlined with an increased number of HLADR CD4 þ positive cells and soluble IL-2 receptor (sIL-2R) level in the blood [4]. Release of Interleukin-5 (IL-5), was shown by Butterfield et al and is thought to be involved in eosinophil proliferation and chemotaxis [5]. However, T lymphocyte activation and especially IL-5 production do not explain all the clinical characteristics.…”

Angioedema Masqueraders

“…been demonstrated in early studies. 33,34 Deposition of eosinophils with degranulation in angioedematous skin is a characteristic histological finding. Recent study confirmed an increase in aberrant CD3 -CD4 + T lymphocytes.…”