结核性胸水中PPD特异性多功能效应型记忆T细胞表型和功能研究

目的:探讨结核性胸水中是否存在纯化蛋白衍生物(PPD)特异性T细胞,并对这群PPD特异性T细胞的表型特征和功能进行研究.方法:体外用PPD刺激结核性胸水细胞(PFCs),结合表面分子和细胞内因子染色方法,分析结核性胸水细胞中PPD特异性的T细胞的表型特征和功能.结果:在不刺激的条件下,结核性胸水细胞几乎不产生细胞因子.PPD刺激结核性胸水细胞后,主要使CD4+ T细胞产生Th1细胞因子.进一步分析Th1细胞因子产生之间相互关系,结果表明PPD特异性CD4+ T 细胞大多同时分泌两种细胞因子.表型分析表明,结核性胸水细胞中分泌Th1细胞因子的主要是CD45RA-CD62L-CD27-CCR7-CD4+ T细胞,即效应型记忆CD4+ T细胞.结论:结核性胸水中存在PPD特异性CD4+ T细胞,这群细胞是多功能效应型记忆CD4+ T细胞,而且可能对结核菌的控制和清除有重要作用.     

八色流式细胞术检测人外周血BCG特异性效应型记忆CD4+T细胞的表型特征

目的:检测BCG刺激后,PPD+正常人外周血中细胞因子产生及其亚群.方法:分离PPD+正常人外周血单个核细胞(PBMC),BCG刺激后检测CD4+和CD8+T细胞细胞因子分泌,并用八色流式细胞术分析BCG特异性T细胞亚群.结果:BCG刺激PBMC后,主要是CD4+T细胞分泌Th1细胞因子(IFN-γ、IL-2和TNF-α),而CD8+T细胞几乎不产生细胞因子.进一步分析分泌细胞因子的细胞亚群,主要是CD4+CD45RO+ CD62L(-)CD27(-)和CD4+ CD45RO+ CD62L(-)CD27+分泌细胞因子.结论:BCG刺激PPD+正常人外周血PBMC后,主要诱导CD4+T细胞分泌细胞因子,且该细胞表现出CD4+CD45RO+ CD62L(-)效应型记忆细胞特征,可能在预防结核感染中发挥重要作用.     

结核胸液中结核抗原刺激后CD4~+T细胞克隆性分析

目的检测结核抗原刺激后结核性胸膜炎病人胸液细胞中CD4+T细胞受体的表达情况,了解CD4+T细胞在结核局部细胞免疫应答中的作用。方法分离结核性胸膜炎病人胸液细胞(PFCs),对比BCG和结核特异性抗原(ESAT-6/CFP10混合单肽)刺激前后CD4+T细胞受体表达特征,并对刺激后部分PCR产物序列进行分析。结果 3例结核性胸膜炎患者胸液细胞未经任何刺激的条件下分别表达17~21个TCR Vβ亚家族,各存在1~2个Vβ亚家族呈现寡克隆增殖趋势。经BCG或ESAT-6/CFP10混合单肽刺激后,患者均出现4~5个寡克隆Vβ亚家族。不同患者选择性刺激的Vβ亚家族不同。结论 BCG和ESAT-6/CFP10混合单肽可分别诱导结核性胸膜炎患者不同TCR Vβ亚家族细胞寡克隆增殖,此优势表达的克隆性T细胞可能与不同结核抗原介导的特异性细胞免疫反应有关。     

结核性胸液T细胞组成和细胞因子表达的探讨

目的:探讨结核性胸液中CD3+ T、CD3+ CD4+ T、CD3+ CD8+ T细胞和CD4+/CD8+比值及细胞因子表达。方法:分离外周血单个核细胞和胸液细胞,流式细胞仪检测CD3+、CD3+ CD4+、CD3+ CD8+和CD4/CD8比值。ELISA法检测胸液上清中IFN-γ、IL-2和TNF-α的水平。流式细胞仪检测CD3+ CD4+和CD3+ CD8+ T细胞Th1细胞因子IL-2、TNF-α、IFN-γ的产生。结果:与外周血相比,胸液细胞CD3+ CD4+ T和CD3+ T细胞比例显著增加。ELISA结果表明,胸液上清中存在大量Th1型细胞因子。流式细胞仪分析结果表明,IL-2、TNF-α和IFN-γ主要由CD3+ CD4+ T细胞产生,而CD3+CD8+T细胞较少或不分泌细胞因子。结论:结核病人胸液中CD3+和CD3+ CD4+ T细胞比例增加,胸液中存在大量Th1细胞因子,且主要来源于CD3+ CD4+ T细胞亚群,可能在抗结核免疫中发挥重要作用。     

结核性胸膜炎患者外周血和胸水γδT和Th17细胞的频率变化及其意义

目的通过检测结核性胸膜炎患者抗结核治疗前后胸水和外周血中γδT细胞和Th17细胞的比例,探讨2群细胞在该病的发生及治疗过程中的变化及意义。方法选取结核性胸膜炎患者30例,分别采集患者抗结核治疗前和治疗后(7～10 d)的胸水及外周血,分离单个核细胞,采用流式细胞术检测γδT和Th17细胞的比例,同时设立健康对照组。结果与健康对照组相比,抗结核治疗前结核性胸膜炎患者外周血中CD3+T细胞比例显著降低(P<0.05),而γδT细胞的比例显著升高(P<0.05),表达IFN-γ的CD3+T和γδT细胞比例均显著升高(P<0.01);患者胸水中的CD3+T和γδT细胞比例显著高于患者外周血(P<0.05),胞内IFN-γ水平与2群细胞变化一致。抗结核治疗后患者外周血和胸水中CD3+T细胞比例较治疗前升高而γδT细胞比例下降,胞内IFN-γ的水平较治疗前显著降低(P<0.05)。抗结核治疗前结核性胸膜炎患者外周血中CD4+T细胞比例较健康对照组显著降低(P<0.01)而Th17细胞比例显著升高(P<0.01);患者胸水中CD4+T细胞显著高于外周血(P<0.05)而Th17细胞比例显著降低(P<0.05)。抗结核治疗后患者胸水中CD4+T和Th17细胞比例较治疗前升高但无显著性差异;IL-17+T与Th17细胞之间无显著相关性,而CD4+RORγt+T与Th17细胞之间存在显著相关性(r=0.564,P<0.05)。结论γδT和Th17细胞在抗结核治疗前后具有显著差异提示2群细胞可能在结核性胸膜炎的发病和治疗中发挥重要作用。     

IL-12对BALB/c小鼠Th17细胞的分化的影响

目的: 观察细胞因子IL-12对Th17细胞分化的影响.方法: 小鼠脾淋巴细胞经抗CD3单克隆抗体(mAb)和不同浓度的重组小鼠IL-12刺激, 3 d后使用ELISA方法观察培养物上清液中IL-17的产生情况.并使用细胞内细胞因子染色的方法, 通过流式细胞术观察CD3 mAb和重组小鼠IL-12刺激对Th1和Th17细胞分化的影响.结果: Th17细胞不分泌IFN-γ、 IL-5、 IL-10等细胞因子, 不表达Foxp3, 是一个独立的细胞亚群.不同浓度的重组小鼠IL-12可以诱导抗CD3 mAb 的T细胞分泌IFN-γ, 并向Th1细胞方向分化.同时, IL-12可以抑制活化的T细胞分泌IL-17, 抑制T细胞向Th17细胞分化.结论: IL-12可以抑制Th17细胞的分化.     

活动性结核病患者外周血单个核细胞中结核分枝杆菌抗原特异性多能CD4+和CD8+T淋巴细胞的特征研究

目的 研究活动性结核病患者外周血单个核细胞中结核分枝杆菌抗原特异性多能T淋巴细胞细胞因子的分泌特征.方法 利用γ干扰素释放试验和多色流式细胞术分析了13例活动性结核病患者、11例肺部感染性/肿瘤疾病患者以及14例健康对照者外周血中结核分枝杆菌抗原特异性(ESAT-6和CFP-10)CD4+Th1和CD8+Tc淋巴细胞表达细胞因子IFN-γ、TNF-α和IL-2的情况.结果 与肺部感染性/肿瘤疾病组和健康对照组相比:(1)活动性结核病组具有较低比例的分泌TNF-α+的CD4+Th1细胞、较高比例的分泌IFN-γ+和IFN-γ+TNF-α+IL-2+的CD4+Th1细胞;(2)活动性结核病组具有较高比例的分泌IFN-γ+TNF-α+IL-2+的CD8+Tc细胞.结论 实验结果提示活动性结核病患者中表达IFN-γ+TNF-α+IL-2+的多能CD4+Th1及CD8+Tc细胞,可能在区别活动性结核病与肺部感染性/肿瘤疾病方面具有一定的临床参考价值.     

口服免疫Ag85A脂质体DNA诱导T细胞亚群应答效应研究

目的:拟采用构建的可在真核细胞内表达Ag85A基因的质粒,以阳离子脂质体为运载体,制成DNA疫苗,经口途径投予小鼠,以观察Ag85A脂质体DNA疫苗诱导免疫应答效应,为口服DNA疫苗的临床应用提供理论和实验依据.方法:ELISA方法检测Ag85A特异性抗体产生水平及血清Th1型细胞因子IFN-γ及Th2型细胞因子IL-4的分泌水平,ELISPOT技术检测口服DNA疫苗后小鼠可分泌IFN-γ和IL-4脾淋巴细胞数量.流式细胞术观察口服DNA疫苗后小鼠脾淋巴细胞CD4+T细胞及CD8+T细胞亚群的变化,从而判断口服DNA疫苗的免疫效果及脂质体是否有免疫增强作用.结果:口服自制Ag85ADNA疫苗可见血清中抗Ag85A特异性抗体的产生;下调了脾CD4+T细胞和CD8+T细胞亚群的数量;分泌IFN-γ的Th1型细胞比率和血清中的IFN-γ水平下降,而分泌IL-4的Th2型细胞比率和血清中的IL-4水平升高.口服DNA疫苗组诱导Ag85A特异性抗体产生,脂质体具有免疫佐剂作用.结论:应用阳离子脂质体为运载体,重组Ag85A DNA疫苗口服免疫C57BL/6小鼠,诱导了CD4+及CD8+T细胞亚群的下调及IFN-γ的表达减少,而玎IL-4的分泌呈增高趋势;疫苗可诱导Ag85A特异性抗体的分泌,产生了明显的体液应答.     

辅助性T细胞9及其功能研究进展

CD4+T细胞在免疫应答反应中发挥关键作用,CD4+T细胞根据其分泌的细胞因子的不同分为多种细胞亚群.其中辅助性T细胞9(Th9)细胞是最近发现的一种新型的CD4+效应T细胞,该细胞由Na(i)ve CD4+T细胞分化而来,可分泌特征性的细胞因子白细胞介素(IL)-9.Th9细胞的发育和分化具有独立的调节机制,其在过敏性炎症、自身免疫病和抗肿瘤免疫中发挥着重要作用.然而,Th9细胞在免疫应答反应中的调控,与其它CD4+T细胞亚群的相互作用及在疾病中的效应作用等问题仍需深入研究.     

人外周血CD4~+ IL-21~+记忆T细胞的特征

目的:探讨人外周血中白细胞介素21(IL-21)的产生细胞及其特征。方法:分离人外周血单个核细胞(PBMC),分为不刺激或anti-CD3(OKT3)、OKT3+anti-CD28、PMA+ionomycin刺激四个组,流式细胞术(FCM)检测产生IL-21的细胞亚群。PMA+ionomycin刺激PBMC、纯化CD4+、CD4+CD45RA-、CD4+CD45RA+细胞、脐带血单个核细胞(CB-MC),FCM分析产生IL-21细胞的表型特征和IL-21与Th1、Th2、Th17和Th22细胞因子之间的关系。结果:与OKT3、OKT3+anti-CD28相比,PMA+ionomycin能诱导最高量的IL-21产生。产生IL-21的主要细胞为CD4+T细胞,少数CD8+T细胞。CD4+IL-21+T细胞表达CD45RO,不表达CD45RA,其中部分细胞表达CCR6、CCR7或CXCR5。CD4+CD45RA-细胞表达IL-21远高于CD4+CD45RA+细胞。进一步研究表明,PBMC产生IL-21,而CBMC不产生。此外,大约24%的CD4+IL-21+细胞表达IFN-γ,小于10%CD4+IL-21+细胞表达IL-4、IL-17或IL-22。结论:人PBMC在多克隆刺激的条件下,可以诱导IL-21的产生。产生IL-21的主要细胞亚群具有记忆CD4+T细胞的表型。其中一部分CD4+IL-21+T细胞的表型独立于Th1、Th2、Th17和Th22细胞亚群。     

Superior T cell activation by ESAT-6 as compared with the ESAT-6-CFP-10 complex

Using intracellular cytokine staining we show herein that T cells will respond to short-term (6 h) activation with phorbol ester plus ionomycin by production of tumor necrosis factor (TNF), IFN-gamma or both. Here CD4 T cells preferentially produce TNF and CD8 cells IFN-gamma. The same pattern is seen when T cells are activated with the Mycobacterium tuberculosis protein early secretory antigenic target-6 (ESAT-6). Responses with >0.02% IFN-gamma+ CD3 cells were seen in 8 of 10 patients diagnosed with tuberculosis and in 12 of 14 healthy individuals selected for likely exposure to M. tuberculosis. T cell responses to the 1:1 complex of ESAT-6 and culture filtrate protein-10 (CFP-10) were inferior to ESAT-6 alone, and only reached the level of T cell response achieved with CFP-10 alone. Extending the time of incubation to 18 h leads to an increased response to the complex, but it still reached only the level of CFP-10 alone. In vitro digestion with lysosomal enzymes cathepsin L and S at 2000:1 protein to enzyme ratio demonstrates rapid digestion of the individual proteins while the ESAT-6-CFP-10 complex is resistant. The data suggest that the natural complex of ESAT-6-CFP-10 is less amenable to antigen processing leading to a lower T cell response as compared with the individual proteins.     

Allergen-induced cytokine phenotypes in mice: role of CD4+ and CD8+ T cell populations

BACKGROUND: CD4+ T cells expressing type 2 cytokines have been implicated in the pathogenesis of asthma to high-molecular-weight allergens. Topical exposure of BALB/c strain mice to low-molecular-weight chemical contact and respiratory allergens stimulates type 1 and type 2 cytokine secretion phenotypes, respectively. OBJECTIVE: To examine the relative frequencies of cytokine-positive CD4+ and CD8+ T cells and their contributions to these cytokine secretion profiles. Methods Draining auricular lymph nodes were isolated 13 days after initiation of topical exposure of female BALB/c strain mice to chemical allergen, or to vehicle alone. The frequency of intracellular cytokine (IL-4 and IFN-gamma)-positive CD4+ and CD8+ lymphocytes was enumerated by flow cytometry. The relative contribution of CD4+ and CD8+ cells to cytokine secretion profiles was assessed by negative selection. RESULTS: Exposure to allergen resulted in an increased frequency of both IFN-gamma+ CD4+ and CD8+ lymphocytes, although there were no marked differences between trimellitic anhydride (TMA)- and 2,4-dinitrochlorobenzene (DNCB)-activated lymph node cells. Treatment with TMA induced approximately five times as many IL-4+ CD4+ cells as did exposure to DNCB. This pattern of cytokine staining was also observed for a further pair of contact and respiratory allergens; respectively, formalin and fluorescein isothiocyanate. CONCLUSION: These data demonstrate that the divergent immune responses induced in mice by different classes of chemical allergen are independent of changes in the frequency of IFN-gamma+ cells, but are associated with differential frequencies of IL-4-expressing CD4+ T cells.     

抗原特异性T细胞的体外扩增及其表型和效应功能检测

目的 探索一种HLA非依赖性的抗原特异性CD+和CD8+T细胞混合型扩增方法.方法 以巨细胞病毒(CMV)IE-1抗原为例,IE-1多肽库体外刺激外周血单个核细胞(PBMC)6 h后,磁珠筛选IFN-γ阳性细胞,加入放射灭活的PBMC于含IL-2的培养基中培养4周.结果 得到1.5×109个细胞,扩增效率达2500倍,其中CD8+T细胞占92.99%,CD4+T细胞6.88%,受阳性靶细胞刺激时,49.2%的T细胞分泌IFN-γ细胞杀伤率达58%(20:1).结论 该方法可在体外有效扩增T细胞,并从细胞因子的分泌及细胞毒杀伤活性分析,初步认为扩增的T细胞保持其表型和抗原特异性效应功能.     

The secretory IFN-gamma response of single CD4 memory cells after activation on different antigen presenting cell types

It is unknown to what extent the heterogeneity of antigen presenting cells (APC) influences the IFN-gamma response of CD4 memory cells. We re-stimulated DO11.10 T cell receptor (TCR)-transgenic cells and wild-type CD4 memory cells with OVA-peptide 323-339 presented on purified dendritic cells (DC), macrophages, and B cells. Using IFN-gamma ELISPOT assays, we measured the number of cytokine producing T cells and the amount of cytokine produced by individual T cells at different time points after antigen encounter. The data showed that, when CD4 cells recognized antigen on DC, the induction of cytokine production was accelerated compared to macrophages and B cells. In contrast, the per-cell cytokine productivity was independent of the type of APC by which the T cells were re-stimulated. Moreover, the peptide concentration required for CD4 cell activation was comparable for the different APC. The data suggest that DC induce cytokine production in memory cells with accelerated activation kinetics, whereas 24 h of antigen stimulation on DC, macrophages, and B cells results in comparable levels of T cell activation. These data have implications for the understanding of T cell memory responses when T cells re-encounter antigen on different APC as well as for the monitoring of memory T cell responses ex vivo.     

CD4+CD25+FoxP3+调节T细胞抑制肺结核患者特异细胞免疫

  目的 了解结核患者外周血中CD4+CD25+FoxP3+调节T细胞在抑制结核患者结核特异细胞免疫反应中的作用。 方法 使用细胞分离、流式细胞分析、细胞增殖和细胞因子测定等方法,比较结核患者及健康正常人群外周血中CD4+CD25+FoxP3+调节T细胞的量及功能特征的差异。 结果 结核患者外周血中CD4+CD25+FoxP3+调节T细胞数占CD4+细胞总数的比例显著高于健康正常人群;在BCG及ESAT-6的刺激下,结核患者外周血单个核细胞增殖能力和产生γ-干扰素的能力比健康正常人群明显增强。在BCG刺激下,结核患者外周血CD4-细胞产生γ-干扰素(1289.62±519.01)及白介素-10(1045.40±534.12)的能力比结核患者外周血BPMCs细胞产生γ-干扰素(624.50±261.13)及白介素-10(377.00±249.56)的能力显著增强(均p<0.05);在BCG及ESAT-6的刺激下,结核患者外周血CD4+CD25+调节T细胞显著抑制结核患者外周血CD4+CD25-细胞产生γ-干扰素及白介素-10。 结论 结核患者CD4+CD25+FoxP3+调节T细胞数量增多,抑制结核患者结核特异细胞免疫反应功能增强,可能与结核的发生、发展及转归有密切关系。     

Diagnosis of Mycobacterium tuberculosis infection using ESAT-6 and intracellular cytokine cytometry

Diagnosis of infection with Mycobacterium tuberculosis (MTB) using tuberculin skin testing (TST) is often hampered by prior Bacille Calmette-Guérin (BCG) vaccination. ESAT-6 is a protein that is expressed by MTB but absent in BCG. It has been postulated that it might be useful in distinguishing MTB-specific immune responses. This study measured CD4 T cell responder frequencies specific for ESAT-6 and the TST reagent purified protein derivative (PPD) in patients with tuberculosis (n = 16), controls with non-tuberculous pneumonia (n = 8) and normal subjects (n = 7). Responses were identified using the intracellular cytokine staining technique and flow cytometry on whole blood samples, and performed blinded to the patient condition. Antigen-specific CD4 cells were defined by CD69 positivity and one or more cytokine [interleukin (IL)-2, IL-4, IL-10, interferon (IFN)-gamma] and/or CD40L positivity. With ESAT-6 stimulation it was found that TB patients had significantly higher frequencies of IFN-gamma and CD40L-positive CD4 T cells compared to the normal group, while no significant differences were measured with PPD stimulation. A responder frequency of 0.01% or higher for at least one of the measured cytokines/CD40L was defined as a positive response. Using this criterion to compare the two patient groups, PPD had 100% sensitivity but 0% specificity while ESAT-6 had 100% sensitivity and 88% specificity. Use of MTB-specific proteins such as ESAT-6 in combination with intracellular cytokine staining and flow cytometry has the potential to identify individuals with MTB infection.     

STAT6 deficiency in a mouse model of allergen-induced airways inflammation abolishes eosinophilia but induces infiltration of CD8+ T cells

BACKGROUND: The TH2-type cytokines have been reported to contribute to the asthmatic response. STAT6 has an essential role in IL-4 signalling and in production of TH2 cytokines from T cells and is involved in IgE and IgG1 responses after nematode infections, indicating that STAT6 has an important role in allergic diseases. OBJECTIVE: In this study we investigated the effects of STAT6 deficiency on allergen-induced airways inflammation in mice. METHODS: Both ovalbumin (OVA)-sensitized STAT6 deficient (STAT6-/-) mice and wild-type C57BL/6 mice were challenged with aerosolized OVA. Changes in inflammatory cell infiltration and cytokine levels in lung tissue as well as serum immunoglobulin levels were analysed in OVA-challenged STAT6-/- and wild-type mice. RESULTS: The eosinophilia and lung damage normally resulting from aeroallergen challenge were not seen in STAT6-/- mice. Expression of TH2 cytokines (IL-4 and IL-5) in the lung tissue as well as IgE and IgG1 responses after OVA challenge were profoundly reduced in STAT6-/- mice, whereas expression of IFNgamma was the same in STAT6-/- mice and wild-type mice after OVA challenge. Immunocytochemical analysis of T cells showed the infiltration of CD4+ T cells but not CD8+ T cells increased into the lung of wild-type mice after OVA challenge. However, the OVA-exposed STAT6-/- mice demonstrated the infiltration of both CD4+ T cells and CD8+ T cells with a significant increase in percentage and total number of CD8+ T cells compared with OVA-exposed wild-type mice. CONCLUSION: These results indicate that factors which signal through STAT6 are important regulators of eosinophilia of allergic airway inflammation, regulating TH2-type cytokine production both in CD4+ T cells and CD8+ T cells.     

Peripheral blood CD4+ and CD8+ T cell type 1 and type 2 cytokine production in atopic asthmatic and normal subjects

BACKGROUND: Increased production of IL-4 and IL-5 and decreased production of IFN-gamma by CD4+ T cells has been implicated in asthma pathogenesis. However, CD8+ T cells also produce type 1 and type 2 cytokines and the relative roles of CD4+ and CD8+ T cell cytokine production in asthma have not been previously studied. OBJECTIVE: To determine the production of the type 1 and type 2 cytokines by CD4+ and CD8+ T cell subsets in asthmatic and normal subjects. METHODS: Intracellular cytokine staining for IL-4, -5, -10, -13 and IFN-gamma was analysed in peripheral blood CD4+ and CD8+ T cells from 24 atopic asthmatic and 20 normal subjects. RESULTS: Both subsets of T cells produced all cytokines studied and there were no significant differences between CD4+ and CD8+ T cells in their capacity to produce either type 1 or type 2 cytokines. There were significantly increased frequencies of IFN-gamma-positive CD4+ (13.1 +/- 2.4%, vs. 7.3 +/- 1.4%) and CD8+ (20.0 +/- 2.9%, vs. 9.6 +/- 2.1%) T cells in asthmatic subjects compared with normal subjects (P < 0.05), but not in frequencies of CD4+ or CD8+ T cells staining positively for IL-4, -5, -10 or -13. CONCLUSION: The frequencies of peripheral blood CD8+ T cells producing type 1 and type 2 cytokines are comparable with the frequencies of CD4+ T cells. There was an increased frequency of IFN-gamma producing CD4+ and CD8+ T cells in asthmatic compared with normal subjects. Further studies investigating T cells derived from the airways and investigating various stages within the disease process are required to further elucidate the importance of type 2 and type 1 T cell cytokine production in the pathogenesis of human allergic disease.     

Cat allergen peptide immunotherapy reduces CD4(+) T cell responses to cat allergen but does not alter suppression by CD4(+) CD25(+) T cells: a double-blind placebo-controlled study

BACKGROUND: We have previously described both modification of allergen immunotherapy using peptide fragments, and reduced regulation of allergen stimulated T cells by CD4(+) CD25(+) T cells from allergic donors when compared with nonallergic controls. It has been suggested that allergen immunotherapy induces regulatory T cell activity: we hypothesized that allergen peptide immunotherapy might increase suppressive activity of CD4(+) CD25(+) T cells. OBJECTIVE: To examine cat allergen-stimulated CD4 T cell responses and their suppression by CD4(+) CD25(+) T cells before and after cat allergen peptide immunotherapy in a double-blind placebo-controlled study. METHODS: Peripheral blood was obtained and stored before and after peptide immunotherapy or placebo treatment. CD4(+) and CD4(+) CD25(+) were then isolated by immunomagnetic beads and cultured with allergen in vitro. RESULTS: Comparing cells from blood taken before with that after peptide immunotherapy there was a significant reduction in both proliferation and IL-13 production by allergen-stimulated CD4+ T cells, whereas no change was seen after placebo. CD4(+) CD25(+) T cells suppressed both proliferation and IL-13 production by CD4(+) CD25(-) T cells before and after therapy but peptide therapy was not associated with any change in suppressive activity of these cells. CONCLUSION: Allergen peptide immunotherapy alters T cell response to allergen through mechanisms other than changes in CD4(+) CD25(+) T cell suppression.