PMC7584932_01
(a) A genital ulcer identified on the inside of the left labia minora (red circle). (b) A 5 mm aphthous ulcer (red circle) on the left side of the tongue.
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In addition, a genital ulcer was identified on the inside of the left labia minora (Figures 1(a) and 1(b)).
(a, A) Enhanced sensitivity of IL-12R and IL-23R leads to the differentiation of naive CD4+ cells to Th1 and Th17 cells (red arrows). (B) IL-1, produced mainly by macrophages, increases the number of Th2 cells via PGE2, and IL-12 and IL-18-activate NK cells (red arrows). (C) When Th17 induction is strong, the induction of regulatory T cells (Tregs) reduces (blue arrow), and immune tolerance cannot be reached. MO: macrophage; Neutro: neutrophil. (b) Th1 cell fraction decreased from 10.1% to 8.1% after prednisolone (PSL) treatment; Th2 cell fraction decreased from 4.2% to 1.6%; and the Th1 to Th2 ratio increased from 2.4 to 5.1. (c) NK cell activity decreased from 56% to 26% after PSL treatment. The patient was administered 10 mg/day PSL for 4 weeks, which improved the immune status.
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AIH through ovulation induction with clomiphene citrate for treating unexplained infertility. After the failure of first AIH, the patient was treated with 10 mg/day prednisolone (PSL) for 4 weeks, which improved the genital ulcer, chronic inflammation (TP, platelet (PLT), CRP, CH50, Fe, and IgG), and immune status (Th2 and NK activity) (Table 1, Figures 2(b) and 2(c)).