Long-term effectiveness and safety of recombinant human interferon gamma therapy for atopic dermatitis despite unchanged serum IgE levels.
Long-term effectiveness and safety of recombinant human interferon gamma therapy for atopic dermatitis despite unchanged serum IgE levels.
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DOI：
10.1001/archderm.134.7.799
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发表时间：
1998-07
影响因子：
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通讯作者：
Seth R. Stevens;Jon M. Hanifin;T. Hamilton;S. Tofte;Kevin D. Cooper;Kevin D. Cooper
中科院分区：
文献类型：
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作者：
Seth R. Stevens;Jon M. Hanifin;T. Hamilton;S. Tofte;Kevin D. Cooper;Kevin D. Cooper
目的 评估重组人干扰素γ治疗特应性皮炎（AD）的长期效果。设计案例系列。患者接受长达24个月的治疗。地点 密歇根州安娜堡和俄勒冈州波特兰的大学皮肤科门诊诊所。 患者 参与先前报道的重组人干扰素 γ 治疗 AD 的为期 12 周、双盲、安慰剂对照研究的 32 名符合条件的患者中，有 24 名患者入组。干预 患者自行注射重组人干扰素 γ，50 微克/平方米，每天皮下注射。主要成果指标 总体反应；受累体表面积；瘙痒、红斑、水肿、表皮脱落、干燥、脱皮和苔藓化的临床严重程度评分；其他特应性症状；每季度访视时监测实验室参数，包括血清 IgE 水平。将 1 年和 2 年的结果与基线值进行比较。结果 所有疗效参数均有所改善 (P<.05)。例如，瘙痒症在 1 (n=24，P<.001) 和 2 (n=16，P=.005) 年后均减少了 50%。过敏性结膜炎和过敏性鼻炎也得到改善（P<.01）。嗜酸性粒细胞计数显着下降 (P<.001)。 IgE 水平升高。与 IgE 水平的变化 (r=0.0-0.2) 相比，临床改善与嗜酸性粒细胞计数的变化 (r=0.3-0.5) 更密切相关。只有 1 名患者因不良反应（流感样症状）而停止治疗。结论 重组人干扰素 γ 治疗 AD 患者的初步疗效和不良反应在长期使用 2 年后仍保持不变。重组人干扰素γ似乎是AD患者长期治疗中耐受性良好且有效的药物。纠正细胞免疫缺陷而非体液免疫缺陷的疗法可能对 AD 患者有效。
OBJECTIVE To assess the long-term effects of recombinant human interferon gamma treatment of atopic dermatitis (AD). DESIGN Case series. Patients were treated for up to 24 months. SETTING University dermatology outpatient clinics in Ann Arbor, Mich, and Portland, Ore. PATIENTS Twenty-four of 32 eligible patients who participated in a previously reported, 12-week, double-blind, placebo-controlled study of recombinant human interferon gamma treatment for AD were enrolled. INTERVENTION Patients self-administered recombinant human interferon gamma, 50 microg/m2, by daily subcutaneous injection. MAIN OUTCOME MEASURES Overall response; body surface area of involvement; clinical severity scores for pruritus, erythema, edema, excoriations, dryness, scaling, and lichenification; other atopic symptoms; and laboratory parameters, including serum IgE levels, were monitored at quarterly visits. Results at 1 and 2 years were compared with baseline values. RESULTS All efficacy parameters improved (P<.05). For example, pruritus was reduced by 50% after both 1 (n=24, P<.001) and 2 (n=16, P=.005) years. Allergic conjunctivitis and allergic rhinitis also improved (P<.01). Eosinophil counts decreased significantly (P<.001). IgE levels increased. Clinical improvement more closely correlated with changes in eosinophil counts (r=0.3-0.5) than with changes in IgE levels (r=0.0-0.2). Only 1 patient discontinued therapy because of adverse effects (flulike symptoms). CONCLUSIONS The initial efficacy and adverse effects reported for recombinant human interferon gamma treatment of patients with AD were maintained after 2 years of long-term use. Recombinant human interferon gamma seems to be a well-tolerated and effective agent in the long-term therapy of patients with AD. Therapies that correct cellular immune defects, but not humoral immune defects, may be effective in the treatment of patients with AD.