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Title:

Modulation of atopy patch test and skin prick test by pretreatment with 1% pimecrolimus cream.

Document type:
Journal Article; Randomized Controlled Trial; Article
Author(s):
Weissenbacher, S; Traidl-Hoffmann, C; Eyerich, K; Katzer, K; Braeutigam, M; Loeffler, H; Hofmann, H; Behrendt, H; Ring, J; Darsow, U
Abstract:
BACKGROUND: In a subgroup of patients with atopic eczema (AE), aeroallergens are relevant eliciting factors. The atopy patch test (APT) was proposed as inflammation model for AE. OBJECTIVE: It was the aim of this study to investigate the effect of pretreatment with 1% pimecrolimus cream (Elidel) on the APT and skin prick test (SPT). METHODS: In a randomized, controlled, double-blind study, 20 patients with AE and positive SPT and APT screening reaction to house dust mite Dermatophagoides pteronyssinus, cat dander, grass or birch pollen were enrolled (age 20 +/- 11 years, 55% males). For 2 weeks, patients twice daily applied pimecrolimus and vehicle control to marked fields on their backs and forearms. Then, APT was performed (200 index of reactivity/g extracts in petrolatum; Stallergènes, France) on both fields on the back and SPT was performed on the pretreated forearms. RESULTS: Including only patients with different readings (n = 13), stronger APT suppression of at least 1 ETFAD (European Task Force on Atopic Dermatitis) grade in the pimecrolimus area versus intraindividual control was observed in 10 of these patients after 48 and 72 h (p < 0.05; 90% CI 50.5-93.4). Including all 20 subjects, the analysis still showed a borderline significance compared with the vehicle (p = 0.0564). SPT with histamine and aeroallergens showed a median 7.5-10% reduction in actively pretreated areas (p = 0.086). Immunohistochemical analysis in 2 patients revealed an induction of interferon-gamma in primecrolimus-pretreated skin. CONCLUSION: APT can be used as a model for AE skin inflammation. It was shown for the first time that pimecrolimus pretreatment has a potential to suppress the development of lesions induced by aeroallergen exposure in patients with AE.
Journal title abbreviation:
Int Arch Allergy Immunol
Year:
2006
Journal volume:
140
Journal issue:
3
Pages contribution:
239-44
Language:
eng
Fulltext / DOI:
doi:10.1159/000093249
Pubmed ID:
http://view.ncbi.nlm.nih.gov/pubmed/16691030
Print-ISSN:
1018-2438
TUM Institution:
Klinik und Poliklinik für Dermatologie und Allergologie
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