Stevens S R, Hanifin J M, Hamilton T, Tofte S J, Cooper K D
Department of Dermatology, Case Western Reserve University and University Hospitals of Cleveland, Ohio 44106-5028, USA.
Arch Dermatol. 1998 Jul;134(7):799-804. doi: 10.1001/archderm.134.7.799.
To assess the long-term effects of recombinant human interferon gamma treatment of atopic dermatitis (AD).
Case series. Patients were treated for up to 24 months.
University dermatology outpatient clinics in Ann Arbor, Mich, and Portland, Ore.
Twenty-four of 32 eligible patients who participated in a previously reported, 12-week, double-blind, placebo-controlled study of recombinant human interferon gamma treatment for AD were enrolled.
Patients self-administered recombinant human interferon gamma, 50 microg/m2, by daily subcutaneous injection.
Overall response; body surface area of involvement; clinical severity scores for pruritus, erythema, edema, excoriations, dryness, scaling, and lichenification; other atopic symptoms; and laboratory parameters, including serum IgE levels, were monitored at quarterly visits. Results at 1 and 2 years were compared with baseline values.
All efficacy parameters improved (P<.05). For example, pruritus was reduced by 50% after both 1 (n=24, P<.001) and 2 (n=16, P=.005) years. Allergic conjunctivitis and allergic rhinitis also improved (P<.01). Eosinophil counts decreased significantly (P<.001). IgE levels increased. Clinical improvement more closely correlated with changes in eosinophil counts (r=0.3-0.5) than with changes in IgE levels (r=0.0-0.2). Only 1 patient discontinued therapy because of adverse effects (flulike symptoms).
The initial efficacy and adverse effects reported for recombinant human interferon gamma treatment of patients with AD were maintained after 2 years of long-term use. Recombinant human interferon gamma seems to be a well-tolerated and effective agent in the long-term therapy of patients with AD. Therapies that correct cellular immune defects, but not humoral immune defects, may be effective in the treatment of patients with AD.
评估重组人干扰素γ治疗特应性皮炎（AD）的长期效果。
病例系列研究。对患者进行长达24个月的治疗。
密歇根州安阿伯市和俄勒冈州波特兰市的大学皮肤科门诊。
参与先前一项关于重组人干扰素γ治疗AD的12周双盲安慰剂对照研究的32名符合条件的患者中有24名被纳入。
患者每日皮下注射50μg/m²重组人干扰素γ进行自我给药。
总体反应；受累体表面积；瘙痒、红斑、水肿、抓痕、干燥、脱屑和苔藓化的临床严重程度评分；其他特应性症状；以及实验室参数，包括血清IgE水平，每季度随访时进行监测。将1年和2年时的结果与基线值进行比较。
所有疗效参数均有改善（P<0.05）。例如，1年（n = 24，P<0.001）和2年（n = 16，P = 0.005）后瘙痒均减轻了50%。过敏性结膜炎和过敏性鼻炎也有所改善（P<0.01）。嗜酸性粒细胞计数显著下降（P<0.001）。IgE水平升高。临床改善与嗜酸性粒细胞计数变化（r = 0.3 - 0.5）的相关性比与IgE水平变化（r = 0.0 - 0.2）更密切。仅1例患者因不良反应（流感样症状）停药。
重组人干扰素γ治疗AD患者最初报道的疗效和不良反应在长期使用2年后得以维持。重组人干扰素γ似乎是AD患者长期治疗中耐受性良好且有效的药物。纠正细胞免疫缺陷而非体液免疫缺陷的疗法可能对AD患者有效。
