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Immunoadsorption for treatment of severe atopic dermatitis.

Authors
  • Wegner, Joanna1
  • Weinmann-Menke, Julia2
  • von Stebut, Esther3
  • 1 Department of Dermatology, University Medical Center Mainz, Germany. , (Germany)
  • 2 1st Department of Medicine, University Medical Center Mainz, Germany. , (Germany)
  • 3 Department of Dermatology, University Medical Center Mainz, Germany. Electronic address: [email protected] , (Germany)
Type
Published Article
Journal
Atherosclerosis. Supplements
Publication Date
Nov 01, 2017
Volume
30
Pages
264–270
Identifiers
DOI: 10.1016/j.atherosclerosissup.2017.05.043
PMID: 29096848
Source
Medline
Keywords
License
Unknown

Abstract

Atopic dermatitis (AD) is a common disease affecting up to 10-20% of the population with the largest disease burden in childhood. Treatment options include basic emollient treatment, topical as well as systemic immunosuppressants. The pathogenesis is complex and among various triggers, genetic predisposition and immunological alterations contribute to development of disease. Atopy is common in patients with AD and many patients have high levels of Immunoglobulin E (IgE), some of which recognizes exogenous or auto/self-allergens. Treatment options targeting IgE such as specific immunotherapy against e.g. house dust mites or using anti-IgE antibodies (omalizumab) showed variable results that were not convincing. We now review recent data on the application of unspecific and IgE-selective immunoadsorption (IA) in AD. All in all, 53 patients have been treated with non-specific pan Ig IA and 28 patients with IgE-selective IA. Side effects were rarely seen. The efficacy of IgE depletion was generally high (<∼80%) for each IA cycle, but transient and lasted only a few days/weeks. Of note, disease activity appeared to improve in almost all cases and lasted for several weeks. Although the evidence is still weak, these case studies suggest that IgE depletion in AD is effective and helped control the disease. The mechanism of action is not understood yet. Future controlled trials are needed to validate this observation.

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