Soluble CD30 and Cyclosporine in Severe Atopic Dermatitis

Abstract

Background: Allergen-reactive Th2-like cells expressing membrane CD30 are present in the circulation of atopic dermatitis (AD) patients during seasonal allergen exposure. Moreover, CD30+ T cells are present in the lesional skin of AD patients and high levels of soluble CD30 (sCD30) are found in the serum of the same atopic patients. To investigate the immunosuppressive capacity of cyclosporin A (CsA) in AD patients, the sCD30 serum level was determined before and after CsA treatment (5 mg/kg/day) in 10 patients with severe, refractory AD. The sCD30 serum levels before and after CsA therapy together with other serum parameters were correlated with disease activity. Methods: sCD30 serum levels were detected using a commercial sandwich ELISA; serum eosinophil cationic protein (ECP) levels were determined using a radioimmunoassay (RIA). Results: In all AD patients sCD30 serum levels were increased ranging from 36 to 300 U/ml, with a mean value equal to 135.7 U/ml. After 6 weeks of CsA treatment, not only was there a significant difference between serum sCD30 levels before (mean 135.7) and after (mean 96.2) treatment but even the serum ECP levels before (mean 57.78) and after (mean 18.69) therapy showed an important reduction. Moreover, no significant difference was found between the mean of serum IgE levels before and after treatment, although the values showed a correlation (p = 0.0003). No significant correlations could be demonstrated between sCD30 levels and serum IgE or between sCD30 and ECP serum levels nor between sCD30 levels and blood eosinophil count after CsA treatment. Moreover, a positive correlation (p = 0.001) was instead documented between sCD30 and the severity of the disease. Conclusions: In this study, CsA therapy results in clinical improvement together with a statistically significant reduction in sCD30 and ECP serum levels in AD patients.

Effects of Korean red ginseng extract on the prevention of atopic dermatitis and its mechanism on early lesions in a murine model

“…KRG and EPO significantly modulated the total IgE levels, while cyclosporine did not. This finding is in line with previous studies, in which the efficacy of cyclosporine on AD was not associated with levels of IgE (Caproni et al, 2000). Cyclosporine was even associated with increased blood IgE in a subset of AD patients (Hijnen et al, 2007).…”

Extremely Rapid and Intense Induction of Apoptosis in Human Eosinophils by Anti-CD30 Antibody Treatment In Vitro

“…If so, blockade of CD30-CD30 ligand signals might reflect the prolongation of eosinophil survival. Clinical observations that the level of sCD30 correlates positively with eosinophilia in Hodgkin's disease (51) and the serum eosinophil cationic protein level in patients with atopic dermatitis (41,42) are quite plausible if sCD30 can inhibit CD30-CD30 ligand signals in vivo (52). Needless to say, secretion of Th2-type cytokines might also participate the eosinophilia seen in these patients (77,78).…”

“…Interestingly, some of these diseases are associated with eosinophilia (47)(48)(49)(50), and an especially positive correlation between the levels of soluble CD30 (sCD30) and eosinophilia was found in Hodgkin's disease (51). A positive correlation between the level of sCD30 and the serum eosinophil cationic protein level was also found in patients with atopic dermatitis (41,42).…”

Contrasting pathogenesis of atopic dermatitis and psoriasis—Part II: Immune cell subsets and therapeutic concepts

“…143 Interestingly, the clinical effects of CsA for AD were not associated with levels of IgE; levels of IgE were even reported to increase in a subgroup of patients. 147,148 In patients with psoriasis, CsA has been shown to suppress the T H 1 and T H 17 cell responses that mediate pathogenesis. 107 Suppression of these immune pathways was linked to reversal of epidermal hyperplasia.…”