Clearance of Inhibitors in Acquired Hemophilia-a during Prednisone Therapy Is Associated with Reduced Ifn-γ and Lt-α Production

Acquired hemophilia A (AH) is an auto-immune disorder cause by polyclonal auto-antibodies (inhibitors) to clotting factor VIII (FVIII). Glucocorticoids (GC) are a standard initial approach to elimination of these inhibitors and are successful in approximately 30% when used alone and about 60% when used in combination with other immuno-modulating therapies. However, the mechanism of action and effect of GC on the immune system are not fully understood. Furthermore, a Th1 (IFN-γ) polarization of the immune response has previously been shown to be associated with inhibitor development. In this report, we delineate the effect of prednisone on the main Th1 cytokine IFN-γ and also on LT-α which has been shown to play a pivotal role in B cell maturation.