Immunologic Changes After Treatment with Thymopentin in Atopic Dermatitis

다국어 초록 (Multilingual Abstract)

Atopic dermatitis patients exhibit multiple immune abnormalities including increased serum IgE levels and impairment of cell mediated immunity, but basic immunological defect is not clear.
In this study, 13 severe atopic dermatitis patients with elevated serum IgE level, but without respiratory allergies were treated with subcutaneous injection of 50 mg thymopentin three times a week for 6 weeks. Helper and suppressor T lymphocytes in peripheral blood and skin lesions were detected with immunofluorescent technique by using CD4 and CD8 monoclonal antibodies. Serum IgE levels and IgE synthesis in the cultured lymphocytes were measured. Cell mediated immunity to recall antigens and clinical changes were observed in order to evaluate the immunological changes after treatment.
The results were as follows:
1. Number of suppressor T lymphocytes in peripheral blood increased at 6 weeks of treatment, but not at 3 weeks. But number of suppressor T lymphocytes in skin lesions increased at 3 and 6 weeks of treatment. Number of helper T lymhocytes in peripheral blood and skin lesions did not change after treatment.
2. IgE levels in the cultured lymphocyte stimulated with thymopentin, interferon gamma and pokeweed mitogen were lower than those of control cultures, before, as well as after, 3 and 6 weeks of treatment. IgE levels in the lymphocyte cultures stimulated with thymopentin and pokeweed mitogen at 6 weeks of treatment were lower than baseline.
Serum IgE level was decreased about 19 percent after treatment but the difference was not statistically significant.
3. Cell mediated immunity to recall antigens evaluated as antigen score and total induration score was significantly improved.
4. Clinical states after treatment were good in 6, fair in 6 and poor in 1 out of 13 patients. First clinical improvement was noted after 5 weeks of treatment.
In conclusion, the initial change after thymopentin treatment is the increment of suppressor T lymphocytes in the skin lesion of atopic dermatitis, rather than the increment of suppressor T lymphocytes in the peripheral blood. This data suggests that basic defect of atopic dermatitis may be an abnormal local suppressor T lymphocyte response.