Insights from a Case of Good’s Syndrome (Immunodeficiency with Thymoma)

Immunodeficiency with thymoma was described by R.A. Good in 1954 and is also named after him. The syndrome is characterized by hypogammaglobulinemia associated with thymoma and recurrent infections, bacterial but also viral, fungal and parasitic. Autoimmune diseases, mainly pure red cell aplasia, other hematological disorders and erosive lichen planus are a common finding. We describe here a typical case exhibiting all these clinical features and report a detailed immunophenotypic assessment, as well as the positivity for autoantibodies against three cytokines (IFN-alpha, IL-6 and GM-CSF), which may add to known immune abnormalities. A review of the published literature, based on case series and immunological studies, offers some hints on the still unsolved issues of this rare condition

Cytokine responses of intraepithelial lymphocytes are regulated by histamine H2 receptor

Backgrounds. Histamine participates in the immune regulation of several gastrointestinal diseases. However, the effect of histamine on intestinal intraepithelial lymphocytes (IELs), the front line of intestinal mucosal immune system, is not well-understood. We examined whether histamine has a direct effect on cytokine production by IELs and the involvement of histamine receptor subtypes.　Methods. Murine IELs were activated by PMA plus ionomycin with/without histamine. Secreted cytokines were measured and compared with those of splenocytes. Intracellular cytokines were detected by flow cytometory. Expression of histamine receptor subtypes in IELs was examined by RT-PCR. Results. Histamine H1 receptor (H1R), H2R, and H4R, but not H3R mRNA were expressed on IELs. Histamine significantly decreased Th1-cytokine (IFN-γ, TNF-α, and IL-2) and also IL-4 production in IELs as well as splenocytes. The selective H2R antagonist famotidine, but not the H1R antagonist pyrilamine nor the H3R/H4R antagonist thioperamide, competes with the inhibitory effect of histamine on these cytokine production in IELs. These suppressive effects of histamine were mimicked by a selective H2R/H4R agonist dimaprit. Further, these suppressive effects of histamine for Th1-cytokine and IL-4 did not accompany with the enhancement of IL-10 production nor IL-10 mRNA level in IELs. Intracellular cytokine analysis revealed that the number of IFN-γ-producingαβ T cells was significantly reduced by histamine in IELs.　Conclusions. Histamine has a direct suppressive effect on IEL-derived cytokines via H2R, which would have a crucial role in the suppression of local immunoregulation in the intestinal epithelium.浜松医科大学学位論文　医博第549号(平成２１年３月１８日