Cyclosporin A treatment is associated with increased serum immunoglobulin E levels in a subgroup of atopic dermatitis patients.
Cyclosporin A is increasingly used in the treatment of severe refractory atopic dermatitis. Although cyclosporin A treatment is highly efficacious and relatively safe, we report four adult atopic dermatitis (AD) patients who deteriorated during long-term cyclosporin A treatment, with clinical signs and symptoms more severe than at the onset of treatment. Interestingly, these patients showed large increases of total serum immunoglobulin E (IgE) levels, paralleled by increasing disease severity and serum levels of thymus and activation-regulated chemokine. This implies that cyclosporin A may induce a shift to Th2, resulting in increased IgE synthesis, in a subpopulation of AD patients. We therefore suggest that in this subpopulation, treatment with anti-B cell or combined anti-B and T-cell treatment may be favorable.
Hijnen
Dirk Jan
DJ
University Medical Center Utrecht, Department of Dermatology & Allergology, The Netherlands. D.J.Hijnen@umcutrecht.nl
Knol
Edward
E
Bruijnzeel-Koomen
Carla
C
de Bruin-Weller
Marjolein
M
D000328:Adult; D016572:Cyclosporine / Q000008:administration & dosage / Q000009:adverse effects*; D003876:Dermatitis, Atopic / Q000097:blood / Q000188:drug therapy* / Q000276:immunology / Q000473:pathology; D003937:Diagnosis, Differential; D004485:Eczema / Q000139:chemically induced / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood*; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects*
D007166:Immunosuppressive Agents; D007073:Immunoglobulin E; D016572:Cyclosporine