[Influence of treating atopic dermatitis with oral antihistamine and topical steroids on selected parameters of cell and humoral immunity].
Pathogenesis of atopic dermatitis (AD) is multifactorial, therefore despite many different treatment protocols none of the available methods is effective enough. In the present study we analysed the effects of oral antihistamines and topical steroids on selected parameters of humoral (immunoglobulin levels) and cellular (lymphocyte proliferation index, granulocyte oxidative burst, lymphocyte phenotype CD4:CD8) immunity. These parameters were analysed in 34 AD subjects during the exacerbation of the disease and after 4 and 12 weeks of the treatment.


RESULTS
Along with the clinical status improvement (change form 3.17 +/- 0.1 to 1.3 +/- 0.2; 0-4 scale; p < 0.001), total serum IgE levels decreased significantly from 1563 +/- 459 to 1266 +/- +/- 364 IU/ml (p < 0.05). Other immunoglobulin levels did not change. Total blood chemiluminescence in response to latex stimulation was relatively higher during exacerbation than during remission, but this difference was not significant (p = 0.1). Mean spontaneous or PMA stimulated chemiluminescence did not differ either. CD4:CD8 index decreased significantly during the treatment (from 2.7 +/- 0.3 to 1.8 +/- 0.2; p = 0.03). Lymphocyte proliferation in response to PHA was significantly lower during exacerbation than during remission (10.4 +/- 2.8 vs. 27.1 +/- +/- 5.2; p < 0.03) and the improvement was observed after first 4 weeks of the treatment reaching the levels found in healthy controls. Proliferation index in response to anti-CD3 mAb (OKT-3) was in turn significantly higher during exacerbation (19.1 +/- 3.4 vs. 11.2 +/- 2.0; p = 0.04).


CONCLUSIONS
Oral antihistamine in combination with topical steroids leads to several significant changes in the immune parameters (IgE levels, CD4:CD8 and proliferation indexes) which may explain its high effectiveness in majority of patients with AD.
Guzik
Tomasz J
TJ
Katedra i Klinika Chorób Wewnetrznych i Medycyny Wsi Collegium Medicum Uniwersytetu Jagiellońskiego Szpital im. J. Dietla ul. Skarbowa 1, 31-121 Kraków.
Adamek-Guzik
Teresa
T
Bzowska
Małgorzata
M
Miedzobrodzki
Jacek
J
Czerniawska-Mysik
Grazyna
G
Pryjma
Juliusz
J
D000284:Administration, Oral; D000287:Administration, Topical; D000328:Adult; D000917:Antibody Formation / Q000187:drug effects; D016516:CD4-CD8 Ratio; D003876:Dermatitis, Atopic / Q000188:drug therapy* / Q000276:immunology*; D005260:Female; D006634:Histamine H1 Antagonists / Q000008:administration & dosage*; D006801:Humans; D007111:Immunity, Cellular / Q000187:drug effects; D008297:Male; D013256:Steroids / Q000008:administration & dosage*
D006634:Histamine H1 Antagonists; D013256:Steroids