Horneff G, Dirksen U, Wahn V
Zentrum für Kinderheilkunde, Universität Düsseldorf, Germany.
Clin Investig. 1994 May;72(5):400-3. doi: 10.1007/BF00252838.
Two 4- and 5-year-old children suffering from refractory atopic dermatitis were treated with recombinant interferon-gamma (rIFN-gamma). rIFN-gamma was injected at 50 micrograms subcutaneously three times a week in the first child for 3 weeks, followed by three times 25 micrograms in week 4. In the other child two treatment courses of 4 weeks were given after a break of 2 weeks. Therapy was well tolerated. In child one reductions in eczematous body surface and severity of lesions were observed, while no beneficial effect was seen in the other. Clinical chemistry data remained unchanged. Immunological studies performed in parallel showed a decrease in total serum IgE of 50% in child 1, a decrease in spontaneous in vitro IgE production, an increase in in vitro production of interleukin-6, and a normalization of previously decreased in vitro lymphocyte responses to several mitogens. While marked immunological changes were noted during IFN-gamma treatment, clinical benefits were not encouraging. Diminished IFN-gamma production has been claimed to be a major pathogenic factor in atopic eczema. Our results indicate that the pathogenesis is more complex. Clinically, we were unable to confirm previous observations in adults. Further studies are needed before IFN-gamma can be recommended for therapy of pediatric atopic eczema.
两名患有难治性特应性皮炎的4岁和5岁儿童接受了重组干扰素-γ（rIFN-γ）治疗。第一个儿童每周皮下注射50微克rIFN-γ，共3周，第4周改为每周3次，每次25微克。另一个儿童在休息2周后进行了两个疗程，每个疗程4周。治疗耐受性良好。第一个儿童的湿疹体表面积和皮损严重程度有所减轻，而另一个儿童未观察到有益效果。临床化学数据保持不变。同时进行的免疫学研究显示，第一个儿童的总血清IgE降低了50%，体外自发IgE产生减少，白细胞介素-6的体外产生增加，并且之前降低的体外淋巴细胞对几种有丝分裂原的反应恢复正常。虽然在IFN-γ治疗期间观察到明显的免疫学变化，但临床益处并不令人鼓舞。有人认为IFN-γ产生减少是特应性湿疹的主要致病因素。我们的结果表明，发病机制更为复杂。临床上，我们无法证实之前在成人中的观察结果。在推荐IFN-γ用于治疗儿童特应性湿疹之前，还需要进一步研究。
