Skip to main content
Log in

New diagnostic tool for differentiation of idiopathic hypereosinophilic syndrome (HES) and secondary eosinophilic states

  • Article
  • Published:
Pathology & Oncology Research

Abstract

The hypereosinophilic syndrome (HES) is a very rare disease, characterized by persistent eosinophilia with tissue involvement and organ dysfunction which often precedes a subsequent T cell lymphoma. Interleukin-5 secreted by a T lymphocyte subpopulation has been described in previous reports as the most important factor responsible for the prolonged lifespan of the eosinophils. The goal of the present study was to describe a fast, simple diagnostic method for the differentiation of HES and secondary eosinophilic states. Beside the surface marker analysis of peripheral blood mononu-clear cells (PBMC) we measured surface bound IgE molecules on lymphocytes and eosinophil cells, intracellular cytokines (IL-5, INFγ) in CD4+ lymphocytes and eosinophil major basic protein (MBP) in eosinophils using flow cytometric detection method. The appearance of an IL-5 producing cell population with a decreased number of INFγ positive lymphocytes was characteristic for the blood samples of HES patients. Predominance of Th2 cells with the appearance of a CD8+/CD3-/CD56+ cell population was restricted for the HES cases and could not be detected in secondary eosinophilic individuals. Our flow cytometric cytokine detection method (with parallel cell surface marker analysis) does not require cell separation or long term cell culture steps previously described for the detection of IL-5 producing cells. Therefore it seems to be a more appropriate approach for the differential diagnosis of primary and secondary eosinophilic states.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Bain BJ: Eosinophilic leukemias and the idiopathic hypere-osinophilic syndrome Br J Haematol 95:2–9, 1996.

    PubMed  CAS  Google Scholar 

  2. Bain BJ: Hypereosinophilia. Curr Opin Hematol 7:21–5, 2000.

    Article  PubMed  CAS  Google Scholar 

  3. Berki T, Kumánovics G, Kumánovics A, et al: Production and flow cytometric application of a monoclonal anti-glucocorticoid receptor antibody. J Immunol Methods 214:19–27, 1998.

    Article  PubMed  CAS  Google Scholar 

  4. Brugnoni D, Airó P, Rossi G, et al: A case of hypereosinophilic syndrome is associated with the expansion of a CD3-CD4+ T-cell population able to secrete large amounts of interleukin-5. Blood 87:1416–1422, 1996.

    PubMed  CAS  Google Scholar 

  5. Chusid MJ, Dale DC, West BC, et al: The hypereosinophilic syndrome: analysis of fourteen cases with review of the literature. Medicine (Baltimore) 54:1–27, 1975.

    Article  CAS  Google Scholar 

  6. Clutterbuck EJ, Hirst EM, Sanderson CJ: Human interleukin-5 (IL-5) regulates the production of eosinophils in human bone marrow cultures: comparison and interaction with IL-1, IL-3, IL-6 and GMCSF. Blood 73:1504–1512, 1989.

    PubMed  CAS  Google Scholar 

  7. Cogan E, Schandené L, Crusiaux A, et al: Clonal proliferation of type 2 helper T cells in a man with the hypereosinophilic syndrome. N Engl J Med 330:535–538, 1994.

    Article  PubMed  CAS  Google Scholar 

  8. Desreumaux P: Synthesis of interleukin-5 by activated eosinophils in patients with eosinophilic heart diseases. Blood 82:1553–1560, 1993.

    PubMed  CAS  Google Scholar 

  9. Kim CJ, Park SH, Chi JG: Idiopathic hypereosinophilic syndrome terminating as disseminated T-cell lymphoma. Cancer 67: 1064–1069, 1991.

    Article  PubMed  CAS  Google Scholar 

  10. Kitano K, Ishikawa N, Shimodaira S, et al: Eosinophilia associated with clonal T-cell proliferation. Leukemia Lymphoma 27:335–342, 1997.

    PubMed  CAS  Google Scholar 

  11. Krug N, Thurau AM, Lackie P, et al: A flow cytometric method for the detection of intracellular basic proteins in unseparated peripheral blood and bone marrow eosinophils. J Immunol Methods 190:245–254, 1996.

    Article  PubMed  CAS  Google Scholar 

  12. Menssen HD, Renkl HJ, Rieder H, et al: Distinction of eosinophilic leukemia from idiopathic hypereosinophilic syndrome by analysis of Wilms’ tumor gene expression. Br J Haematol 101:325–334. 1998.

    Article  PubMed  CAS  Google Scholar 

  13. Metz J, McGrath KM, Savoia HF, et al: T cell lymphoid aggregates in bone marrow in idiopathic hypereosinophilic syndrome. J Clin Path 46:955–958. 1993.

    Article  PubMed  CAS  Google Scholar 

  14. Oliver JW, Deol I, Morgan DL, et al: Chronic eosinophilic leukemia and hypereosinophilic syndromes. Proposal for classification, literature review and report of a case with a unique chromosomal abnormality. Cancer Gen Cytogen 107:111–117, 1998.

    Article  CAS  Google Scholar 

  15. Owen WF, Rothenberg ME, Petersen J: Interleukin-5 and phenotipically altered eosinophils in the blood of patients with the hypereosinophilic syndrome. J Exp Med 170:343–348, 1989.

    Article  PubMed  CAS  Google Scholar 

  16. Pinto A, Aldinucci D, Gloghini A, et al: The role of eosinophils in the pathobiology of Hodgkin’s disease. Ann Oncol 8:89–96, 1997.

    Article  PubMed  Google Scholar 

  17. Raghavachar A, Fleicher S, Frickhofen N, et al: T lymphocyte control of human eosinophilic granulopoiesis. Clonal analysis in an idiopathic hypereosinophilic syndrome. J Immunol 139:3753–3758, 1987.

    PubMed  CAS  Google Scholar 

  18. Rauch AE, Amyot KM, Ducc HG, et al: Hypereosinophilic syndrome and myocardial infarction in a 15-year-old. Pediatric Pathol Lab Med 17:469–486, 1997.

    Article  CAS  Google Scholar 

  19. Roufosse F, Schandene L, Sibille C, et al: T-cell receptor-independent activation of clonal Th2 cells associated with chronic hypereosinophilia. Blood 94:994–1002, 1999.

    PubMed  CAS  Google Scholar 

  20. Roufosse F, Schandene L, Sibille C, et al: Clonal Th2 lymphocytes in patients with the idiopathic hypereosinophilic syndrome. Br J Haematol 109:540–8, 2000.

    Article  PubMed  CAS  Google Scholar 

  21. Satoh T, Sun L, Li MS, et al: Interleukin-5 mRNA levels in blood and bone marrow mononuclear cells from patients with the idiopathic hypereosinophilic syndrome. Immunology 83:308–312, 1994.

    PubMed  CAS  Google Scholar 

  22. Schrezenmeier H, Thomé SD, Tewald F, et al: Interleukin-5 is the predominant eosinophilopoietin produced by cloned T lymphocytes in hypereosinophilic syndrome. Exp Hematol 21:358–365. 1993

    PubMed  CAS  Google Scholar 

  23. Simon HU, Plotz SG, Dummer R, et al: Abnormal clones of T cells producing interleukin-5 in idiopathic eosinophilia. N Engl J Med 341:1112–1120, 1999.

    Article  PubMed  CAS  Google Scholar 

  24. Sornasse T, Larenas PV, Davis KA, et al: Differentiation and stability of Th1 and Th2 cells derived from naive human neonatal CD4+ T cells, analyzed at the single cell level. J Exp Med 84:473–483, 1996.

    Article  Google Scholar 

  25. Staynov DZ, Lee TH: Expression of interleukin-5 and granulocytemacrophage colony-stimulating factor in human peripheral blood mononuclear cells after activation with phorbol myristate acetate. Immunology 75:196–201, 1992.

    PubMed  CAS  Google Scholar 

  26. Tai PC, Sun L, Spry CJ: Effects of IL-5, granulocyte/macrophage colony stimulating factor (GM-CSF) and IL-3 on the survival of human blood eosinophils in vitro. Clin Exp Immunol 85:312–316, 1991.

    PubMed  CAS  Google Scholar 

  27. Trainor KJ, Brisco MJ, Wan JH, et al: Gene rearrangement in B-and T-lymphoproliferative disease detected by the polymerase chain reaction. Blood 78:192–196, 1991.

    PubMed  CAS  Google Scholar 

  28. Walsh GM: Human eosinophils: Their accumulation, activation and fate. Br J Haematol 97:701–709, 1997.

    Article  PubMed  CAS  Google Scholar 

  29. Weller PF, Bubley GJ: The idiopathic hypereosinophilic syndrome. Blood 83:2759–2779, 1994.

    PubMed  CAS  Google Scholar 

  30. Weller PF: The immunobiology of eosinophils. N Engl J Med 324:1110–1118, 1991.

    Article  PubMed  CAS  Google Scholar 

  31. Yamaguchi Y, Suda T, Ohta S, et al: Analysis of the survival of mature human eosinophils: Interleukin-5 prevents apoptosis in mature human eosinophils. Blood 78:2542–2547, 1991.

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Tímea Berki.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Berki, T., Dávid, M., Bóné, B. et al. New diagnostic tool for differentiation of idiopathic hypereosinophilic syndrome (HES) and secondary eosinophilic states. Pathol. Oncol. Res. 7, 292–297 (2001). https://doi.org/10.1007/BF03032386

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF03032386

Keywords

Navigation