Effect of Cyclophosphamide upon the Immune Response in Wegener's Granulomatosis

Abstract

Nine patients with Wegener's granulomatosis were studied before and after treatment with cyclophosphamide alone. The study was undertaken to determine any immunologic abnormalities associated with the disease, to observe the effect of cyclophosphamide on the clinical course, as well as on the immune response in man, and to observe any correlation between clinical response and immunosuppression. Untreated patients had elevated mean serum IgA levels of 470 as compared with 200 mg per 100 ml in normal controls and elevated mean parotid-fluid secretory IgA levels of 4.7 as compared with 1.8 mg per 100 ml in normal controls. Seven of nine patients receiving cyclophosphamide had undetectable humoral and delayed hypersensitivity responses to a new antigenic stimulus, and five of the seven retained previously established delayed hypersensitivity. A favorable clinical response to cyclophosphamide and immunosuppression appeared to be correlated.