EFFECT OF PREDNISOLONE ON LEUKOCYTE FUNCTION IN MAN - DOUBLE-BLIND CONTROLLED-STUDY

Abstract

The effect of prednisolone on various immunological parameters was studied in patients with ulcerative colitis in complete remission. The study was designed as a double blind trial in which patients received either prednisolone or a dummy preparation and the following observations were made: The mean lymphocyte count fell from 1738 cells/mm3 to 501 cells/mm3 4 h after prednisolone was given but by 24 h was significantly elevated to 2399 cells/mm3; thereafter it returned to normal levels. Surface marker assays of lymphocytes forming spontaneous sheep cell (E), Fc (EA), and C3 [complement component 3] (EAC) rosettes; and cells bearing surface immunoglobulin fluctuated in approximately the same pattern as the total lymphocyte count. The mitotic response to a sub-maximal stimulating dose of phytohemagglutinin (PHA) was significantly depressed 4 h after steroid administration but returned to normal by 24 h. Spontaneous and PHA-induced lymphocyte mediated cytotoxicity fell significantly by 4 h and remained depressed to the end of steroid administration. The PHA-induced cytotoxicity was still significantly depressed 7 days after steroid administration was stopped. K cell cytotoxicity did not follow the general pattern and was only slightly reduced at 4 h being lowest after 24 h and still depressed 7 days after cessation of steroid administration. The number of plasma cells in the rectal lamina propria showed no significant change after 1 wk of steroid administration. No significant changes occurred in any of the above assays, in the control group. Polymorphonuclear leukocyte counts rose sharply by 4 h in the patients receiving prednisolone. There was also a smaller but significant rise in the control group. They remained elevated for 7 days in the group receiving prednisolone, and subsequently fell to normal levels. The control group had returned to initial levels by 24 h. No significant difference in the bactericidal capacity of polymorphs or the opsonising capacity of patients'' sera was observed at any stage in the study.