Immunotherapy with Systemic Interferon-gamma in Severe Atopic Dermatitis

Noh, Geunwoong; Lee, Woo Gill

Abstract

PURPOSE
Atopic dermatitis is characterized by immunologic abnormalities including evidence for reduced IFN-gamma production with increased IL-4 production. Previous open trials have suggested efficacy for recombinant IFN-gamma in treatment of severe atopic dermatitis. Here we report the results of treatment with IFN-gamma in 5 patients with moderate to severe atopic dermatitis.
METHODS
Atopic dermatitis was diagnosed according to typical clinical symptoms. Patients were treated with IFN-gamma for 6 weeks. Patients received 2x106 units/m2 IFN-gamma by subcutaneous injection. Serum IgE levels, total eosinophil counts with hemoglobin(Hb) concentrations, hematocrit(Hct)s, white blood cell counts(WBC), lymphocyte fractions, eosinophil fractions and platelet counts were examined before treatment and 1 week and 6 week after treatment.
RESULTS
The skin lesions of all patients begun to be improved after 3 times of injection. As estimated by patients, responses showed significant improvement. Three of five patients were resolved completely who showed complete clearance of skin manifestation. and remained two patients show dramatic improvement with mild some skin lesions. WBC counts, Hemoglobins, Hematocrits, lymphocyte fractions, eosinophil fractions and platelet counts was not significantly changed before and after IFN-gamma treatment. Serum IgE levels were not markedly elevated and not reduced after IFN-gamma treatment. But total eosinophil counts were decreased 1 week after treatment and reduced to normal range 6 weeks after treatment.
CONCLUSIONS
Five severe atopic dermatitis patients who did not respond to previous treatment, who had showed complication to local steroid treatment and who had severe skin lesions were treated with IFN-gamma. They showed marked improvement in skin lesions after IFN-gamma treatment and three of them showed complete clearance of skin lesions. Total eosinophil count was regarded as an excellent indicator for diagnosis, evaluation of therapeutic effects of IFN-gamma. IFN-gamma may be a suitable immunotherapy modality in the treatment of atopic dermatitis and futher studies for the action mechanism of IFN-gamma in atopic dermatitis might be needed.