Night Sweats Explained?

[Guest guest]

An article in Current Topics in Microbiol Immunology

(2000;252:293-300) may shed some light on why night

sweats occur in CLL.

R. P. Phipps and others at the University of Rochester

School of Medicine and Dentisty in Rochester NY

explored the role COX-2 enzyme plays in CLL. (COX-2

is involved in the body's inflammatory response, and

over-expression has been determined to be a

significant factor in several cancers, primarily

colorectal and pancreatic cancer.)

They report that some B-cell patients have elevated

levels of an inflammatory compound called PGE2, a

prostaglandin produced with the help of the COX-2

enzyme. (Prostaglandins are targets of aspirin and

other pain relievers, thus their fever and

inflammation reduction ability.) Their studies show

that some CLL cells have 'significant' amounts of

COX-2. After an 18 hour incubations with stimulating

drugs in vitro, B-CLL cells can be induced to express

even higher levels of COX-2.

Non-malignant lymphocytes appear to be more mature,

and do not seem to overexpress COX-2, nor do they seem

to produce PEG2. These researchers say that the

'expression of COX-2 by B lymphocytes may be a

characteristic that is required for the transformation

to a malignant phenotype'.

In CLL patients, high PGE2 levels have been associated

with fever, night sweats, wight loss and recurrent

infections.

Thus, it appears that CLL cells themselves, through

the excretion of PGE2, may directly cause B symptoms

such as night sweats, even without the presence of

fever.

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