Recombinant gamma interferon in treatment of patients with atopic dermatitis and elevated IgE levels

Abstract

purpose: Recombinant gamma interferon (rIFN-γ) inhibits IgE synthesis in vitro by human peripheral blood mononuclear cells (PBMC). These data suggest a role for rIFN-γ in the treatment of patients with severe atopic dermatitis (AD) and elevated IgE levels. The purpose of this study was to determine the effect of rIFN-γ treatment on IgE production in patients with AD. patients and methods: Twenty-two patients with chronic severe AD were treated with rIFN-γ. In part I of the study, 14 patients were treated with daily subcutaneous injections at three successive dose levels (0.01 mg/m 2, 0.05 mg/m 2, and 0.1 mg/m 2) for 5 days with 2 days off between each dose level. In part II, eight patients received rIFN-γ at 0.05 mg/m 2, daily for 6 weeks. One patient from part I and eight patients from part II of the study received three times per week maintenance therapy for up to 14 months. Prior to and at selected times during and after treatment, the clinical and immunologic status of the patients was assessed. results: In part I, spontaneous de novo IgE synthesis by PBMC was inhibited in 10 patients receiving rIFN-γ at 0.05 mg/m 2 (p = 0.038) and in nine at 0.1 mg/m 2 (p = 0.066). There was no reduction of serum IgE levels at any of the three dose levels. Total clinical severity showed improvement at each dose level (p <0.04) with worsening 3 days after discontinuation of treatment. In part II, there was no significant inhibition of spontaneous IgE synthesis by PBMC nor was there any reduction of serum IgE. Nevertheless, there was a progressive and significant reduction (p <0.01) in total clinical severity over the 6 weeks of daily rIFN-γ with a sustained improvement during maintenance therapy. conclusion: The results of this pilot study suggest that rIFN-γ may be efficacious in the treatment of AD and that further clinical trials are warranted.