Selective enhancement of production of IgE, IgG4, and Th2-cell cytokine during the rebound phenomenon in atopic dermatitis and prevention by suplatast tosilate.

Abstract

BACKGROUND:

Atopic dermatitis is a chronic inflammatory skin disease, which is commonly treated with topical steroids. It is, however, associated with rebound after therapy has been discontinued.

OBJECTIVE:

This study was designed to elucidate the mechanisms of the rebound phenomenon, and to test the effect of an oral anti-allergic medication, suplatast tosilate, on atopic dermatitis.

METHODS:

This is a randomized, placebo controlled study. Patients with atopic dermatitis who had been treated with strong steroid ointment (dexamethasone valerate) for several years were divided into two groups. One group (the control group, n = 15) was treated with a non-steroid anti-inflammatory ointment (bufexamac ointment), while the other group (the suplatast tosilate group, n = 17) was treated with the anti-allergic medications, suplatast tosilate and bufexamac ointment. In each group, in vitro production of immunoglobulins and cytokines before and after 2 weeks of treatment was measured.

RESULTS:

In the control group, 15 of the 15 patients experienced rebound and mean production of IgE, IgG4, IL-4, IL-5, IL-10, and IL-13 was enhanced after 2 weeks. In contrast, only 2 of the 17 patients in the suplatast tosilate group experienced rebound. There was no enhancement of production of immunoglobulins and cytokines after 2 weeks of treatment.

CONCLUSION:

Enhanced production of the Th2-cell cytokines, which selectively induces IgE and IgG4 production, may be involved in the pathogenesis of the rebound phenomenon, and that suplatast tosilate may prevent the rebound phenomenon by down-regulating the production of these cytokines.

• Authors: H Kimata
• Journal: Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology (Ann Allergy Asthma Immunol) Vol. 82 Issue 3 Pg. 293-5 (Mar 1999) ISSN: 1081-1206 [Print] United States
• PMID: 10094221 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial)

Chemical References

• Anti-Allergic Agents
• Anti-Inflammatory Agents
• Anti-Inflammatory Agents, Non-Steroidal
• Arylsulfonates
• Histamine Antagonists
• Immunoglobulin G
• Interleukins
• Lymphokines
• Sulfonium Compounds
• Immunoglobulin E
• Bufexamac
• Dexamethasone
• suplatast tosilate
• dexamethasone 17-valerate

Topics

• Administration, Oral
• Administration, Topical
• Adolescent
• Adult
• Anti-Allergic Agents (administration & dosage, therapeutic use)
• Anti-Inflammatory Agents (administration & dosage, therapeutic use)
• Anti-Inflammatory Agents, Non-Steroidal (administration & dosage, therapeutic use)
• Antibody Formation (drug effects)
• Arylsulfonates (administration & dosage, therapeutic use)
• Bufexamac (administration & dosage, therapeutic use)
• Dermatitis, Atopic (drug therapy, immunology)
• Dexamethasone (adverse effects, analogs & derivatives, therapeutic use)
• Female
• Histamine Antagonists (administration & dosage, therapeutic use)
• Humans
• Immunoglobulin E (biosynthesis)
• Immunoglobulin G (biosynthesis)
• Interleukins (biosynthesis, metabolism)
• Lymphokines (metabolism)
• Male
• Substance Withdrawal Syndrome (etiology, immunology, prevention & control)
• Sulfonium Compounds (administration & dosage, therapeutic use)
• Th2 Cells (metabolism)
• Treatment Outcome