Abstract

We have studied the modulation of circulating soluble interleukin-2 receptor (sIL-2R) levels by glucocorticoids in subjects with different states of immune activation. In contrast to normal subjects, 40 mg methylprednisolone administration over 6 days resulted in a significant fall of elevated circulating sIL-2R levels (p<0.05) in patients with active atopic dermatitis, most pronounced in those patients showing the highest pre-treatment levels of sIL-2R and scores of disease activity. Following administration of 1 mg dexamethasone, sIL-2R levels remained unchanged both in normal subjects and patients with atopic dermatities. Circulating sIL-2R levels were significantly decreased in patients with long-term hypercortisolism due to Cushing's disease (p<0.05) and significantly elevated (p<0.05) in hypocortisolemic patients. Blockade of adrenal cortisol secretion by 1.5 g metyrapone did not change sIL-2R levels in normal subjects and sIL-2R levels were not affected in depressive patients, either before of after clinical remission or following 1.5 g metyrapone administration. These data suggest that the effect of glucocorticoid administration on circulating sIL-2R levels depends on the state of immune activation and the duration of glucocorticoid exposure. The circulating sIL-2R levels show significant changes in patients with chronic alterations of endogenous glucocorticoid secretion and in response to prolonged glucocorticoid therapy in disorders with immune activation.

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