Osawa Kouji, Etoh Takafumi, Ariyoshi Noritaka, Ishii Itsuko, Ohtani Michteru, Kariya Satoru, Uchino Katsuyoshi, Kitada Mitsukazu
Graduate School of Pharmaceutical Sciences, Chiba University, Chiba, Japan.
J Dermatol. 2007 Aug;34(8):531-6. doi: 10.1111/j.1346-8138.2007.00326.x.
Kaposi's varicelliform eruption is the most important problem in treating patients with atopic dermatitis (AD) with tacrolimus ointment. It has been considered that Kaposi's varicelliform eruption occurs due to decreased levels of interleukin (IL)-18. The aim of this study was to examine the relationship between Kaposi's varicelliform eruption and genetic polymorphisms in the IL-18 gene. IL-18 gene promoter polymorphisms were analyzed in 21 AD patients treated with tacrolimus ointment and in 100 healthy volunteers. Six AD patients with Kaposi's varicelliform eruption during the treatment with tacrolimus ointment showed significantly higher frequency in G-to-C mutations at the IL-18 gene promoter region -137 compared with 15 AD patients without Kaposi's varicelliform eruption. The 15 AD patients without Kaposi's varicelliform eruption as well as 100 healthy volunteers did not have mutations of G-to-C at the IL-18 gene promoter region -137. These results suggest that the onset of Kaposi's varicelliform eruption following the treatment with tacrolimus ointment is associated with the mutation of G-to-C in the IL-18 gene promoter region -137, and that caution is required when using tacrolimus ointment for treating AD patients with this mutation.
卡波西水痘样疹是他克莫司软膏治疗特应性皮炎（AD）患者时最重要的问题。人们认为卡波西水痘样疹是由于白细胞介素（IL）-18水平降低所致。本研究的目的是探讨卡波西水痘样疹与IL-18基因多态性之间的关系。对21例接受他克莫司软膏治疗的AD患者和100名健康志愿者进行了IL-18基因启动子多态性分析。与15例未发生卡波西水痘样疹的AD患者相比，6例在他克莫司软膏治疗期间发生卡波西水痘样疹的AD患者在IL-18基因启动子区域-137处G到C的突变频率显著更高。15例未发生卡波西水痘样疹的AD患者以及100名健康志愿者在IL-18基因启动子区域-137处均未发生G到C的突变。这些结果表明，他克莫司软膏治疗后卡波西水痘样疹的发生与IL-18基因启动子区域-137处G到C的突变有关，使用他克莫司软膏治疗具有这种突变的AD患者时需要谨慎。
