Immunomodulation in patients with chronic hand eczema treated with oral alitretinoin
| Autor: | Margitta Worm, Mandana Schindler, Anja A. Kühl, Gennadiy Drozdenko |
|---|---|
| Rok vydání: | 2013 |
| Předmět: |
Adult
CD4-Positive T-Lymphocytes Male medicine.medical_treatment Immunology Eczema Tretinoin T-Lymphocytes Regulatory Flow cytometry Alitretinoin Immune system Immunology and Allergy Medicine Humans Immunologic Factors Aged integumentary system biology medicine.diagnostic_test business.industry CD23 Interleukin General Medicine Immunoglobulin E Middle Aged Flow Cytometry Hand Immunohistochemistry Cytokine Chronic Disease biology.protein Cytokines Female Interleukin 17 Antibody business medicine.drug |
| Zdroj: | International archives of allergy and immunology. 165(1) |
| ISSN: | 1423-0097 |
| Popis: | Background: Oral alitretinoin (9-cis-retinoic acid; 9-cis-RA) has shown clinical efficacy in patients with chronic hand eczema (CHE). Herein, we investigated the impact of oral 9-cis-RA on the local and systemic immune response in patients with CHE. Methods: Twenty patients with CHE were treated with oral alitretinoin (10 or 30 mg/day) for at least 24 weeks. Blood samples were taken for flow cytometry, and serum samples were assessed by ELISA to determine immunoglobulin (Ig) levels. Skin biopsies from lesional skin were evaluated immunohistochemically. Results: Upon 9-cis-RA treatment, improvement of the CHE was observed in all patients. A significant decrease in plasmablasts in the peripheral blood and a significant reduction of serum IgE levels were determined. Furthermore, we detected a significant reduction of CD4+ cells and regulatory T cells in the peripheral blood upon treatment. By contrast, these cell subsets were significantly increased in the affected skin. Cytokine analysis of activated CD154-positive T cells showed a reduction of interleukin (IL)-17 but not of IL-4 or IFN-γ production. Conclusions: Overall, our data indicate a disease-modifying effect of 9-cis-RA, including a systemic decrease in IL-17-positive cells, but decreased serum IgE and CD23 expression. The increased frequency of FoxP3-positive cells in the skin upon treatment may suggest a mechanism by which hand eczema is therapeutically targeted by 9-cis-RA, but this will need to be proven in the future studies. |
| Databáze: | OpenAIRE |
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