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Promising results were reported by adding arsenic trioxide to zidovudine and IFN.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Here we assessed Th1\/Th2\/T<jats:sub>reg<\/jats:sub> cytokine gene expression profiles in 16 ATL patients before and 30 days after treatment with arsenic\/IFN\/zidovudine, in comparison with HTLV-I healthy carriers and sero-negative blood donors. ATL patients at diagnosis displayed a T<jats:sub>reg<\/jats:sub>\/Th2 cytokine profile with significantly elevated transcript levels of Foxp3, interleukin-10 (IL-10), and IL-4 and had a reduced Th1 profile evidenced by decreased transcript levels of interferon-\u03b3 (IFN-\u03b3) and IL-2. Most patients (15\/16) responded, with CD4<jats:sup>+<\/jats:sup>CD25<jats:sup>+<\/jats:sup> cells significantly decreasing after therapy, paralleled by decreases in Foxp3 transcript. Importantly, arsenic\/IFN\/zidovudine therapy sharply diminished IL-10 transcript and serum levels concomittant with decrease in IL-4 and increases in IFN-\u03b3 and IL-2 mRNA, whether or not values were adjusted to the percentage of CD4<jats:sup>+<\/jats:sup>CD25<jats:sup>+<\/jats:sup> cells. Finally, IL-10 transcript level negatively correlated with clinical response at Day 30.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>The observed shift from a T<jats:sub>reg<\/jats:sub>\/Th2 phenotype before treatment toward a Th1 phenotype after treatment with arsenic\/IFN\/zidovudine may play an important role in restoring an immuno-competent micro-environment, which enhances the eradication of ATL cells and the prevention of opportunistic infections.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/1742-4690-10-91","type":"journal-article","created":{"date-parts":[[2013,8,20]],"date-time":"2013-08-20T14:16:02Z","timestamp":1377008162000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":45,"title":["The combination of arsenic, interferon-alpha, and zidovudine restores an \u201cimmunocompetent-like\u201d cytokine expression profile in patients with adult T-cell leukemia lymphoma"],"prefix":"10.1186","volume":"10","author":[{"given":"Ghada","family":"Kchour","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"SA Rahim","family":"Rezaee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reza","family":"Farid","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akram","family":"Ghantous","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Houshang","family":"Rafatpanah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahdi","family":"Tarhini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamad-Mehdi","family":"Kooshyar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiba","family":"El Hajj","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fadwa","family":"Berry","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamad","family":"Mortada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roudaina","family":"Nasser","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abbas","family":"Shirdel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zeina","family":"Dassouki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamad","family":"Ezzedine","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hossein","family":"Rahimi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ardeshir","family":"Ghavamzadeh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hugues","family":"de Th\u00e9","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivier","family":"Hermine","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahmoud","family":"Mahmoudi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Bazarbachi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2013,8,20]]},"reference":[{"key":"3592_CR1","doi-asserted-by":"publisher","first-page":"631","DOI":"10.1002\/ijc.2910290606","volume":"29","author":"Y Hinuma","year":"1982","unstructured":"Hinuma Y, Komoda H, Chosa T, Kondo T, Kohakura M, Takenaka T, Kikuchi M, Ichimaru M, Yunoki K, Sato I, et al: Antibodies to adult T-cell leukemia-virus-associated antigen (ATLA) in sera from patients with ATL and controls in Japan: a nation-wide sero-epidemiologic study. 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