Evidence that thalidomide modifies the immune response of patients suffering from actinic prurigo.
BACKGROUND
Actinic prurigo (AP) is a photodermatosis with a restricted ethnic distribution, mainly affecting Mestizo women (mixed Indian and European). The lesions are polymorphic and include macules, papules, crusts, hyperpigmentation and lichenification. Thalidomide, an effective immunomodulatory drug, was first used successfully to treat AP in 1973. In this work we describe the effect that thalidomide had on TNF-alpha sera levels and on IL-4- and IFN gamma (IFNgamma)-producing lymphocytes of actinic prurigo (AP) patients.


METHODS
Actinic prurigo patients were analyzed before and after thalidomide treatment. The percentage of IL-4+ or IFNgamma+ CD3+ lymphocytes was analyzed in eight of them by flow cytometry. TNFalpha in sera was measured by ELISA in 11 patients.


RESULTS
A direct correlation was observed between resolution of AP lesions and an increase in IFNgamma+ CD3+ peripheral blood mononuclear cells (P < or = 0.001) and a decrease in TNFalpha serum levels (no statistical difference). No IL-4+ CD3+ cells were detected.


CONCLUSIONS
Our findings confirm that AP is a disease that has an immunological component and that thalidomide clinical efficacy is exerted not only through inhibition of TNFalpha synthesis, but also through modulation of INFgamma-producing CD3+ cells. These cells could be used as clinical markers for recovery.
Estrada-G
Iris
I
Depto. de Inmunología, Escuela Nacional de Ciencias Biológicas, IPN, Centro de Investigaciones y Estudios Avanzados, IPN, México, DF. iestrada@encb.ipn.mx
Garibay-Escobar
Adriana
A
Núñez-Vázquez
Angela
A
Hojyo-Tomoka
Teresa
T
Vega-Memije
Elisa
E
Cortés-Franco
Roberto
R
Pérez-Uribe
Adriana
A
Flores-Romo
Leopoldo
L
Santos-Argumedo
Leopoldo
L
Estrada-Parra
Sergio
S
Domínguez-Soto
Luciano
L
D000293:Adolescent; D000328:Adult; D017252:CD3 Complex / Q000276:immunology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007371:Interferon-gamma / Q000097:blood; D015847:Interleukin-4 / Q000097:blood; D008800:Mexico; D008875:Middle Aged; D010787:Photosensitivity Disorders / Q000188:drug therapy / Q000208:ethnology / Q000276:immunology; D011446:Prospective Studies; D011536:Prurigo / Q000188:drug therapy / Q000208:ethnology / Q000276:immunology*; D012074:Remission Induction; D013601:T-Lymphocytes / Q000187:drug effects / Q000276:immunology; D013792:Thalidomide / Q000627:therapeutic use*; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis / Q000037:antagonists & inhibitors
D017252:CD3 Complex; D007166:Immunosuppressive Agents; D014409:Tumor Necrosis Factor-alpha; D015847:Interleukin-4; D013792:Thalidomide; D007371:Interferon-gamma