Ustekinumab treatment in severe atopic dermatitis: Down-regulation of T-helper 2/22 expression

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• 作者：Doris Weiss ; MD^a ; Michaela Schaschinger ; BS^a ; Robin Ristl ; PhD^b ; Robert Gruber ; MD^c ; ^d ; Tamara Kopp ; MD^e ; Georg Stingl ; MD^a ; Christine Bangert ; MD^a ; ^{christine.bangert@meduniwien.ac.at}
• 关键词：anti-interleukin-12/-23 p40 ; atopic dermatitis ; cytokines ; eczema ; inflammatory ; T helper 2 ; T helper 17 ; T helper 22 ; ustekinumab
• 刊名：Journal of the American Academy of Dermatology
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：76
• 期：1
• 页码：91-97.e3
• 全文大小：1936 K
• 卷排序：76

文摘

It has recently been suggested that patients with moderate to severe atopic dermatitis (AD) may profit from anti-interleukin (IL)-12/-23 p40 therapy.ObjectiveWe sought to assess the immunologic effects of ustekinumab treatment on AD skin and to correlate them with the clinical efficacy of this drug.MethodsWe investigated the course of 3 patients with severe AD who were administered 45 mg of subcutaneous ustekinumab over a period of 16 weeks. Clinical scores and skin biopsy specimens, taken at baseline and at week 8, were used to assess changes in disease severity.ResultsAll patients showed a gradual improvement of the disease, achieving a 50% reduction in the Eczema Area and Severity Index score by week 16. Immunohistology of skin biopsy specimens revealed a significant decrease in the degree of epidermal hyperplasia/proliferation and the number of infiltrating dermal T cells, dendritic cells, and mast cells after treatment. Using quantitative real-time polymerase chain reaction of lesional skin, we found a clear reduction of T-helper 2-/22-associated molecules after therapy.LimitationsThe small number of patients (n = 3) limits efficacy analysis and warrants prospective placebo-controlled studies in larger patient cohorts.ConclusionBlocking IL-12/-23 p40 could be beneficial for a subgroup of patients with severely infiltrated AD.