Changes of serum levels of interleukin-2, intercellular adhesion molecule-1, endothelial leukocyte adhesion molecule-1 and Th1 and Th2 cell in severe atopic dermatitis after intravenous immunoglobulin therapy

被引:38
作者
Huang, JL
Lee, WY
Chen, LC
Kuo, ML
Hsieh, KH
机构
[1] Chang Gung Childrens Hosp, Div Allergy Asthma & Rheumatol, Dept Pediat, Tao Yuan, Taiwan
[2] Chang Gung Univ, Tao Yuan, Taiwan
关键词
D O I
10.1016/S1081-1206(10)62785-8
中图分类号
R392 [医学免疫学];
学科分类号
100102 ;
摘要
Objective: To evaluate the effect of intravenous immunoglobulin (IVIG) in the treatment of severe intractable atopic dermatitis (AD) in children and to investigate the inflammatory markers used to measure their disease activity. Materials and Methods: Serum levels of interleukin-2 receptor (sIL-2R), intercellular adhesion molecule-1 (ICAM-1), endothelial leukocyte adhesion molecule (ELAM-1), and eosinophil cationic protein (ECP) were measured in five children with AD (group A) who had a mean age of 9.4 months (range 7 to 12 months) before and after IVIG therapy. Seven age-matched patients with similar severity of AD who only received topical corticosteroid therapy served as the control group (group B). Ten normal control serum samples were collected from well-baby clinic (group C). T helper 1 (Th1) was defined by IFN-gamma/CD4(+) and Th2 by IL-4/CD4(+), using 3-colored flow cytometry. Clinical severity of AD was evaluated with the SCORAD index. Intravenous immunoglobulin (2 g/kg/dose) was administered monthly for a total of 3 doses. Results: The serum levels of ICAM-1, ELAM-1, and IL-2R in patients with AD were significantly higher than normal control infants. After IVIG therapy, the SCORAD index and the inflammatory markers (ICAM-1, ELAM-1, and ECP) in group A were significantly decreased (P = .01 for SCORAD index; .034, .043, and .03 for ICAM-1, ELAM-1 and ECP, respectively). The serum levels of ICAM-1, ELAM-1, ECP and IL-2R in group B did not show a significant reduction after 3 months of topical corticosteroid therapy. In comparison to normal healthy children, patients with AD had decreased Th2 cells (P = .009) and higher ratio of Th1/Th2 (P = .009) in peripheral blood mononuclear cells (PBMC). There was no significant difference of Th1, Th2 cells, and ratio of Th1/Th2 in PBMC before and after IVIG therapy in patients with AD. Conclusion: Intravenous immunoglobulin can be safely and effectively given for the treatment of severe intractable AD. The determination of ICAM-1, ELAM-1, and ECP levels may be useful in monitoring disease activity of AD in childhood. The IVIG may play a role in treatment.
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收藏
页码:345 / 352
页数:8
相关论文
共 21 条
[1]  
[Anonymous], ACTA DERM VENERE S92, DOI [10.2340/00015555924447, DOI 10.2340/00015555924447]
[2]   Cyclosporine in severe childhood atopic dermatitis: A multicenter study [J].
BerthJones, J ;
Finlay, AY ;
Zaki, I ;
Tan, B ;
Goodyear, H ;
LewisJones, S ;
Cork, MJ ;
Bleehen, SS ;
Salek, MS ;
Allen, BR ;
Friedmann, P ;
Harper, J ;
Camp, RDR ;
Smith, S ;
GrahamBrown, RAC .
JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY, 1996, 34 (06) :1016-1021
[3]   RECOMBINANT GAMMA INTERFERON IN TREATMENT OF PATIENTS WITH ATOPIC-DERMATITIS AND ELEVATED IGE LEVELS [J].
BOGUNIEWICZ, M ;
JAFFE, HS ;
IZU, A ;
SULLIVAN, MJ ;
YORK, D ;
GEHA, RS ;
LEUNG, DYM .
AMERICAN JOURNAL OF MEDICINE, 1990, 88 (04) :365-370
[4]   Proliferation and production of interferon-gamma (IFN-gamma) and IL-4 in response to Staphylococcus aureus and Staphylococcal superantigen in childhood atopic dermatitis [J].
Campbell, DE ;
Kemp, AS .
CLINICAL AND EXPERIMENTAL IMMUNOLOGY, 1997, 107 (02) :392-397
[5]   Prostaglandin E(2) control of T cell cytokine production is functionally related to the reduced lymphocyte proliferation in atopic dermatitis [J].
Chan, S ;
Henderson, WR ;
Li, SH ;
Hanifin, JM .
JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY, 1996, 97 (01) :85-94
[6]  
*EUR TASK FORC AT, 1993, DERMATOLOGY, V183, P23
[7]   LESIONAL EXPRESSION OF INTERFERON-GAMMA IN ATOPIC ECZEMA [J].
GREWE, M ;
GYUFKO, K ;
SCHOPF, E ;
KRUTMANN, J .
LANCET, 1994, 343 (8888) :25-26
[8]   A role for Th1 and Th2 cells in the immunopathogenesis of atopic dermatitis [J].
Grewe, M ;
Bruijnzeel-Koomen, CAFM ;
Schöpf, E ;
Thepen, T ;
Langeveld-Wildschut, AG ;
Ruzicka, T ;
Krutmann, J .
IMMUNOLOGY TODAY, 1998, 19 (08) :359-361
[9]   Monitoring of disease activity by measurement of inflammatory markers in atopic dermatitis in childhood [J].
Halmerbauer, G ;
Frischer, T ;
Koller, DY .
ALLERGY, 1997, 52 (07) :765-769
[10]   In vivo expression of IL-12 and IL-13 in atopic dermatitis [J].
Hamid, Q ;
Naseer, T ;
Minshall, EW ;
Song, YL ;
Boguniewicz, M ;
Leung, DYM .
JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY, 1996, 98 (01) :225-231