IgE-Selective Immunoadsorption for Severe Atopic Dermatitis

Autor: Michael Kasperkiewicz, Sophie-Charlotte Mook, Diana Knuth-Rehr, Artem Vorobyev, Ralf J. Ludwig, Detlef Zillikens, Philip Muck, Enno Schmidt
Jazyk: angličtina
Rok vydání: 2018
Předmět:
Zdroj: Frontiers in Medicine, Vol 5 (2018)
Druh dokumentu: article
ISSN: 2296-858X
DOI: 10.3389/fmed.2018.00027
Popis: IntroductionRecent reports proposed the application of immunoadsorption (IA) for patients with recalcitrant atopic dermatitis (AD) and high-serum IgE levels. However, experience with this novel treatment approach, especially with the newly available IgE-specific adsorber, is limited and recommendation for its use in clinical practice awaits evidence from more studies.Materials and methodsPatients with severe AD (SCORAD ≥ 60) and total serum IgE levels ≥750 kU/L were included in this study. The treatment protocol consisted of two cycles of five consecutive treatments with IgE-selective IA 3 weeks apart.ResultsTen patients were enrolled and four patients completed the study. The mean SCORAD was significantly improved by up to 43% within a few weeks and until the end of a 6-month follow-up period, with 50% of patients achieving an at least 50% individual reduction of the baseline SCORAD. Each IA cycle induced a temporal average decrement of total serum levels of IgE, IgM, IgA, and IgG by 92, 43, 38, and 35%, respectively. Except for one case of Staphylococcus aureus septicemia, no major adverse events occurred.ConclusionAlthough limited by a considerable withdrawal rate, our observations strengthen our and other recent results further suggesting that IgE-selective IA is an effective treatment option for patients severely affected by AD with highly elevated IgE levels.
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