Pediatric allergy and respiratory disease (소아알레르기 및 호흡기학회지)

The Korean Academy of Pediatric Allergy and Respiratory Diseasse (대한소아알레르기호흡기학회)
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Long-term Effect of Recombinant Interferon-Gamma on Moderate and Servere Atopic Dermatitis in Childhood

중등증 이상의 소아 아토피피부염에서 재조합 IFN- $\gamma$의 장기적 효과에 대한 연구

Kim, Hyun-A;Yoon, So-Won;Yum, Myung-Gul;Kim, Chang-Ryul;Lee, Se-Min;Lee, Ha-Baik;Oh, Jae-Won
김현아;윤소원;염명걸;김창렬;이세민;이하백;오재원

  • Published : 20080900
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Abstract

Purpose : A number of studies on the treatment of atopic dermatitis have focused on the therapeutic effects of interferon-gamma (IFN-γ) in patients with severe atopic dermatitis, although therapeutic protocols such as duration and dosage of recombinant IFN-γ were different among studies. The beneficial effects of IFN-γ have probably been attributed mainly to its immune modulating effect on the expression of several immunologic mediators although the mechanism of action of IFN-γ therapy in atopic dermatitis is not clear. Objective : The purpose of the present study was to evaluate the therapeutic effect of recombinant IFN-γ on moderate to severe atopic dermatitis with changes in immunologic markers such as IgE level and eosionophil cationic protein (ECP). Methods : Thirty children with moderate to severe atopic dermatitis were selected for the treatment with recombinant IFN-γ, and 10 children with atopic dermatitis were recruited for the controls without IFN-γ treatment. They were followed up every 4 weeks for 3 months after IFN-γ treatment. We evaluated the SCORAD index and immunologic markers including serum IgE and ECP and total eosinophil and neutrophil counts. Results : Significant clinical improvement in reduced SCORAD index was observed 12 weeks after treatment with regimen of recombinant IFN-γ. This clinical outcome was correlated more with changes in eosinophil counts and ECP levels than with those in serum IgE levels. Conclusions : The efficacy of recombinant human IFN-γ therapy for children with moderate to severe atopic dermatitis was maintained without serious side effects for 6 months after final injection of recombinant IFN-γ. Recombinant IFN-γ therapy corrected cellular immune deficits, but not humoral immune defects in patients with atopic dermatitis.

목 적 : IFN-γ는 IL-4의 생성과 IL-4수용체의 발현을 억제하고 Th2 세포의 여러 작용들과 길항함으로써 아토피피부염의 치료에 대해 아직 논란의 여지가 많다. 이에 본 연구에서 재조합 IFN-γ를 알레르기성 아토피피부염 환아에게 투여하여 임상증상의 장기적 추적관찰과 치료 전후의 혈액 IgE 치 및 혈액 호산구, 호중구와 eosinophilic cationic protein의 농도 변화를 살펴보고자 하였다. 방 법 : 2005년 7월 1일부터 2006년 6월 30일까지 한양대학교 구리병원 소아 알레르기클리닉을 내원한 아토피피부염 환아 중 치료군 30명과 대조군 10명을 선정하여 연구를 시행하였으며 치료군에게 단위 체표 면적당 200 IU의 재조합 IFN-γ를 12주간 매주 3회 피하주사 하였고 비치료군 환아들은 같은 기간 동안 치료를 시행하지 않은 후 두 군에서 치료 전, 방문 1회, 2회(4주), 3회(8주), 4회(12주)에 임상증상과 알레르기 혈액 검사를 시행하여 치료군과 대조군을 비교하였다. 결 과 : 재조합 IFN-γ를 투여한 치료군의 환아에서 임상증상 지표인 SCORAD 지수가 대조군의 환아보다 유의하게 감소하였고(P<0.05) 혈액학적으로는 호산구, 백혈구, ECP 농도가 유의하게 감소하였으며(P<0.05) 혈청 IgE 치는 두 군간, 그리고 치료군에서 치료 전후에서 큰 변화는 보이지 않았다.(P>0.05) 결 론 : 아토피피부염 환아에게 재조합 IFN-γ를 투여한 결과 임상증상이 호전되었고 혈액학적으로 호산구, 백혈구, ECP 농도가 유의하게 감소 하였다. 이는 아토피피부염 치료에 IFN-γ투여가 장기적으로 도움이 될 것으로 사료된다.

Keywords

References

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