Daeschlein Georg, Scholz Sebastian, Lutze Stine, Eming Ruediger, Arnold Andreas, Haase Hermann, Hertl Michael, Jünger Michael
Department of Dermatology, University of Greifswald, Greifswald, Germany.
Department of Dermatology and Allergology, University of Marburg, Marburg, Germany.
Ther Apher Dial. 2015 Jun;19(3):279-87. doi: 10.1111/1744-9987.12267. Epub 2014 Dec 16.
The purpose of the study was to investigate the clinical efficacy of repetitive IgE immunoadsorption (IA) cycles in severe atopic dermatitis (AD) with high serum IgE levels. A total of seven patients with severe AD with a history of no significant or longterm Scoring Atopic Dermatitis (SCORAD) reduction and total serum IgE levels >700 IU/mL were enrolled. The patients received one to five series of IA (Ig-Therasorb adsorber columns; Miltenyi Biotec, Teterow, Germany) each consisting of five consecutive treatments which were performed on a monthly regimen. Overall, one patient received one, two patients two, one patient three, two patients four and one patient five cycles of IA. IA was well tolerated in all the studied AD patients and led to a significant decrease of SCORAD and IgE levels during each IA cycle in all the patients. The relative decrease of SCORAD and serum IgE levels after treatment was 11.1% and 80%, respectively, after five immunoadsorption series, 24.1% and 83.6%, respectively, after four series, 37.6% and 75.9%, respectively, after three series, 27.9% and 74.2%, respectively, after two series, and 25.1% and 74.8% after the 1st IA cycle. One of the patients exhibited a long lasting clinical benefit over more than 12 months after the 5th IA cycle. Repetitive IA with more than two cycles at intervals of 4 weeks induces a profound and persisting IgE reduction which is remarkable clinical efficacy improving SCORAD in severe AD with high serum IgE levels.
本研究的目的是探讨重复进行免疫球蛋白E（IgE）免疫吸附（IA）疗程对血清IgE水平高的重度特应性皮炎（AD）患者的临床疗效。共纳入7例重度AD患者，这些患者既往无显著的或长期的特应性皮炎评分（SCORAD）降低情况，且血清总IgE水平>700 IU/mL。患者接受1至5个IA疗程（Ig-Therasorb吸附柱；德国美天旎生物技术公司，泰特罗），每个疗程由连续5次治疗组成，每月进行一次。总体而言，1例患者接受1个疗程，2例患者接受2个疗程，1例患者接受3个疗程，2例患者接受4个疗程，1例患者接受5个疗程的IA治疗。在所有研究的AD患者中，IA耐受性良好，并且在所有患者的每个IA疗程中均导致SCORAD和IgE水平显著下降。治疗后，5个免疫吸附疗程后SCORAD和血清IgE水平的相对下降分别为11.1%和80%，4个疗程后分别为24.1%和83.6%，3个疗程后分别为37.6%和75.9%，2个疗程后分别为27.9%和74.2%，第1个IA疗程后分别为25.1%和74.8%。其中1例患者在第5个IA疗程后12个月以上表现出持久的临床获益。每隔4周重复进行超过2个疗程的IA可诱导IgE深度且持续降低，这在改善血清IgE水平高的重度AD患者的SCORAD方面具有显著的临床疗效。
