Ustekinumab treatment in severe atopic dermatitis: Down-regulation of T-helper 2/22 expression - 18/04/17
Abstract |
Background |
It has recently been suggested that patients with moderate to severe atopic dermatitis (AD) may profit from anti-interleukin (IL)-12/-23 p40 therapy.
Objective |
We sought to assess the immunologic effects of ustekinumab treatment on AD skin and to correlate them with the clinical efficacy of this drug.
Methods |
We investigated the course of 3 patients with severe AD who were administered 45 mg of subcutaneous ustekinumab over a period of 16 weeks. Clinical scores and skin biopsy specimens, taken at baseline and at week 8, were used to assess changes in disease severity.
Results |
All patients showed a gradual improvement of the disease, achieving a 50% reduction in the Eczema Area and Severity Index score by week 16. Immunohistology of skin biopsy specimens revealed a significant decrease in the degree of epidermal hyperplasia/proliferation and the number of infiltrating dermal T cells, dendritic cells, and mast cells after treatment. Using quantitative real-time polymerase chain reaction of lesional skin, we found a clear reduction of T-helper 2-/22-associated molecules after therapy.
Limitations |
The small number of patients (n = 3) limits efficacy analysis and warrants prospective placebo-controlled studies in larger patient cohorts.
Conclusion |
Blocking IL-12/-23 p40 could be beneficial for a subgroup of patients with severely infiltrated AD.
Le texte complet de cet article est disponible en PDF.Key words : anti-interleukin-12/-23 p40, atopic dermatitis, cytokines, eczema, inflammatory, T helper 2, T helper 17, T helper 22, ustekinumab
Abbreviations used : AD, EASI, IL, mRNA, Th
Plan
| Supported by the Department of Dermatology, Division of Immunology, Allergy, and Infectious Diseases (DIAID), Medical University of Vienna, Austria. For each patient, the first 3 doses of ustekinumab were provided by Janssen-Cilag. |
|
| Disclosure: Dr Stingl has/had consultancy arrangements with Abbott, Affiris, Amgen, Bayer, Delenex, Eli Lilly, Galderma, Janssen, Merck, Novartis, and Pfizer; received grants from Novartis, Abbott, and Pfizer; received payments for lecturing and participating in advisory boards from Abbott, Abbvie, Delenex, Janssen, Merck, and Novartis; and received royalties for coauthoring a textbook on dermatology. Dr Bangert received payments for lecturing from Novartis and Bayer and participated in advisory boards of Novartis, Meda, and Celgene. Dr Kopp received payments for lecturing from Novartis and Merck. Drs Weiss, Ristl, and Gruber, and Ms Schaschinger have no conflicts of interest to declare. |
|
| Presented as a poster at the European Society for Dermatological Research, September 9-12th, 2015, Rotterdam, The Netherlands. |
|
| Supplemental materials available at www.jaad.org. |
|
| Reprints not available from the authors. |
Vol 76 - N° 1
P. 91 - janvier 2017 Retour au numéro
Article précédent
- Cardiovascular event risk assessment in psoriasis patients treated with tumor necrosis factor-? inhibitors versus methotrexate
- Jashin J. Wu, Annie Guérin, Murali Sundaram, Katherine Dea, Martin Cloutier, Parvez Mulani
- Ten-year mortality is increased after hospitalization for atopic dermatitis compared with the general population, but reduced compared with psoriasis
- Alexander Egeberg, Lone Skov, Yuki M.F. Andersen, Lotus Mallbris, Gunnar H. Gislason, Jonathan I. Silverberg, Jashin J. Wu, Jacob P. Thyssen
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?