Serum immunoglobulins, IL-1beta, IL-2, and IFN-gamma gamma level in patients with lymphedema treated with ortho-beta-hydroxy-ethyl rutosides (HR).

BACKGROUND

This investigation was undertaken to study the clinical characteristics and the humoral immune pattern in lymphedema patients undergoing O-beta-hydroxy-ethyl rutoside therapy.

METHODS

A complete physical examination was performed on 27 lymphedema patients (postmastectomy and postphlebitis) and 17 healthy controls. Clinical evaluation of affected limbs was carried out concerning swelling, circumference, mobility, and tissue tension, while immunologic studies consisted of serum IgG, IgA, IgM, C3, and 1-glycoprotein, interleukin-1 beta, interleukin-2, and IFN-gamma levels. Immunoglobulins and alpha-1-acid glycoprotein were assessed by radial immune diffusion (RID) and interleukin levels, by ELISA (R & D Systems Kits, R & D Systems, Minneapolis, MN, USA). On admission, patients received O-beta-hydroxy-ethyl rutosides (HR) 1 g/day during a period of 6 months.

RESULTS

These demonstrated several clinical, functional, and immunologic alterations in lymphedema patients. HR treatment produced a remarkable reduction in swelling, circumference, and tissue tension, and an improvement in mobility. In addition, edema was also diminished. The immunologic profile observed in untreated lymphedema patients is as follows: IgG and alpha-1-acid glycoprotein concentration were slightly diminished in comparison with the control group, reaching normal levels after therapy. The difference among these values was significant (p <0.001). Contrariwise, normal C3 values were detected with a significant posttreatment decrease (p <0.001). Normal serum IgA and IgM levels in patients with lymphedema before and after HR treatment are shown, and are similar to those of the control group. In addition, Il-1beta and IL-2 values are higher in relation to control values (p <0.01), attaining normal concentration after therapy. Normal levels of IFN-gamma were found in lymphedema patients, and there was no difference with control values. The concentration of this cytokine was not influenced by HR. IL-1beta and IL-2 concentrations were higher than in controls (p <0.001). Values reached normal levels after therapy (p <0.01).

CONCLUSIONS

Diverse clinical and immunologic alterations were evidenced in lymphedema patients. The immunoglobulin profile and IL-1beta and IL-2 levels were also modified. After HR treatment, their improvement was reflected by the favorable effect regarding the previously mentioned alterations. O-beta-hydroxy-ethyl rutosides are effective both clinically and immunologically.