Activation of pulmonary T cells in corticosteroid-resistant and -sensitive interstitial pneumonitis in dermatomyositis/polymyositis

Clin Exp Immunol. 2002 Sep;129(3):541-8. doi: 10.1046/j.1365-2249.2002.01933.x.


To study the activation states and cytokine profiles of pulmonary T cells in corticosteroid-resistant and corticosteroid-sensitive interstitial pneumonitis (IP) in dermatomyositis (DM)/polymyositis (PM), we examined the activation markers and cytokine profiles of T cells in bronchoalveolar lavage fluids (BALF) from patients with IP in DM/PM before prednisolone therapy and then compared the activation states of T cells according to the therapeutic response of IP to prednisolone therapy. CD25+ CD4+ T cells in BALF were significantly increased in both corticosteroid-resistant and corticosteroid-sensitive IP in DM/PM as compared with those in controls without IP. Furthermore, CD25+ CD4+ T cells in BALF were significantly more increased in corticosteroid-resistant IP than those in cortico teroid- sensitive IP. Moreover, CD25+ CD8+ T cells in BALF were significantly increased only in corticosteroid-resistant IP, but not in corticosteroid-sensitive IP or controls without IP. IFN-gamma mRNA was detected in BALF T cells in corticosteroid-resistant and corticosteroid-sensitive IP but not in controls without IP, whereas IL-4 mRNA was virtually undetected in BALF T cells in both the IP groups. However, there were no significant differences in CD4/CD8 ratio of BALF T cells, HLA-DR+ BALF T cells or CD25+ and HLA-DR+ peripheral blood T cells between the two IP groups. These results indicate that activated Th1-type pulmonary T cells play an important role in the development of corticosteroid- resistant IP in DM/PM and that the increase in CD25+ CD8+ T cells in BALF is a useful indicator for corticosteroid-resistant IP in DM/PM and hence may be an indicator for early use of cyclosporin.

Publication types

  • Clinical Trial
  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Bronchoalveolar Lavage Fluid / cytology
  • Bronchoalveolar Lavage Fluid / immunology
  • Dermatomyositis / drug therapy
  • Dermatomyositis / immunology
  • Drug Resistance
  • Female
  • Glucocorticoids / therapeutic use*
  • HLA-DR Antigens / analysis
  • Humans
  • Interferon-gamma / biosynthesis
  • Interferon-gamma / genetics
  • Lung / immunology
  • Lung Diseases, Interstitial / drug therapy*
  • Lung Diseases, Interstitial / immunology*
  • Lymphocyte Activation
  • Male
  • Middle Aged
  • Polymyositis / drug therapy*
  • Polymyositis / immunology*
  • Prednisolone / therapeutic use*
  • RNA, Messenger / biosynthesis
  • Receptors, Interleukin-2 / analysis
  • T-Lymphocyte Subsets / classification
  • T-Lymphocyte Subsets / immunology
  • T-Lymphocytes / immunology*


  • Glucocorticoids
  • HLA-DR Antigens
  • RNA, Messenger
  • Receptors, Interleukin-2
  • Interferon-gamma
  • Prednisolone