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The efficacy of thalidomide (
-phthalimido-glutarimide) therapy in leprosy patients with erythema nodosum leprosum is thought to be due to inhibition of tumor necrosis factor
. In other diseases reported to respond to thalidomide, the mechanism of action of the drug is unclear. We show that thalidomide is a potent costimulator of primary human T cells in vitro, synergizing with stimulation via the T cell receptor complex to increase interleukin 2–mediated T cell proliferation and interferon
production. The costimulatory effect is greater on the CD8+ than the CD4+ T cell subset. The drug also increases the primary CD8+ cytotoxic T cell response induced by allogeneic dendritic cells in the absence of CD4+ T cells. Therefore, human T cell costimulation can be achieved pharmacologically with thalidomide, and preferentially in the CD8+ T cell subset.
Key Words: thalidomide costimulation T cells CD8+ pharmacologic immune modulation
Abbreviations used: DC, dendritic cell; ENL, erythema nodosum leprosum; ER, erythrocyte-rosetting; GAF, glutaraldehyde-fixed; r-hu, recombinant human; SEA and SEB, staphylococcal enterotoxin A and B.
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