Autologous Immunoglobulin Therapy in Patients With Severe Recalcitrant Atopic Dermatitis: A Preliminary Report

Abstract

The management of severe recalcitrant atopic dermatitis (AD) is a challenging issue for clinicians and patients. We hypothesized that repeated intramuscular injections of autologous immunoglobulin (autologous immunoglobulin therapy: AIGT) might induce clinical improvements in patients with AD by stimulation of the active immune response to antigen-binding-site of pathogenic antibodies. We tried AIGT in 3 adult patients with severe recalcitrant AD whose clinical conditions could not be effectively controlled by medical treatments (including oral cyclosporine) for more than 2 years. Autologous immunoglobulin was purified from the autologous plasma by affinity chromatography using Protein A. The patients were treated by an intramuscular injection of 50 mg of autologous immunoglobulin twice a week for 4 weeks. A clinical severity score of AD (SCORAD value) showed a decrease greater than 30% at 8 weeks after the initiation of AIGT compared with the baseline before the initiation of AIGT in all 3 patients with severe recalcitrant AD. No significant side effects from treatment were observed. Further studies with larger numbers of patients are required to evaluate the clinical usefulness of AIGT for AD.

Clinical Efficacy of Subcutaneous Allergen Immunotherapy in Patients with Atopic Dermatitis

“…This result suggested that immune dysfunction and hypersensitivity reaction play key roles in the pathogenesis of AD and could be the critical therapeutic targets for AD 3. Further development of a new therapeutic modality is required to change the long-term clinical course of AD 356…”

A Systematic Review of Autohemotherapy as a Treatment for Urticaria and Eczema

“…Yu [18] Incomplete or internal inconsistent results in abstract; full article not available Jeon [53] No results related to research questions Sheikhi [54] Insufficient detail in letter to compute effect size or describe design; no further information available Nahm [55] Treatment consisted of autologous immunoglobulin, not whole blood or serum…”

Effects of Intramuscular Injection of Autologous Immunoglobulin on Clinical Severity and Serum IgE Concentration in Patients with Atopic Dermatitis

“…In this study, relatively short-term (12 weeks) changes in clinical severity and laboratory parameters after initiation of AIGT were evaluated. However, further long-term clinical improvements lasting more than 6 months after 4 weeks of AIGT were observed in 2 of 3 patients with severe AD in our previous report [8]. Decreases in peripheral blood eosinophil counts and serum total IgE concentrations could also be observed 6-12 months after initiation of AIGT in the 2 patients with severe AD who showed long-term clinical improvements in that previous report [unpubl.…”

“…In this study, autologous immunoglobulin was purified by affinity chromatography using Protein A, and the immunoglobulin isotype used for AIGT was mainly IgG (purity ≥97%) with small amounts of IgM, IgA, and IgE, as reported previously [8,12]. The clinical efficacy and anti-inflammatory properties of polyclonal human IgG purified from multiple healthy blood donors have been reported in various allergic and autoimmune diseases [24].…”

“…Recently, we reported a preliminary result of AIGT on clinical severity in 3 patients with severe recalcitrant AD [8]. In this study, we further evaluate the effect of AIGT on clinical severity and serum IgE concentrations in 17 patients with severe AD.…”