Two Cases of Atopic Dermatitis Treated with Thymopentin / 대한피부과학회지

ABSTRACT

The pat,hogenesis of atopic dermititis(AD) is still undefined. The prominent immunologic abnormalities associated with AD are defective cell-mediated immunity and increased IgE production. Also, the predominant CD4 subset in the skin lesion of AD is a Th2-like. Thymopentin, the active pentapepide of a thymic hormone, promotes differentiation of thymocytes and exhibits immunomodulating function. We experienced 2 case. of severe AD patients who were treated with subcutaneous injection of thymopentin three times a week for 6 weeks or 8 weeks. We compared the effects of cyclosporine A(CsA), FK -506 and thymopentin on the production of IL-2, IL-3, IL-4 and sIL-2R in vitro. In patient 1, there was no clinical response with thymopentin therapy. There was no difference in the serum IgE levels between before and after treatment. The ratio of Th/Ts was increased after treatment. In vitro study, CsA and FK-506 inhibited the production of IL-2, IL-3, IL 4 and sIL-2R, and thymopentin inhibited the production of IL-2, IL-3, IL-4 and sIL-2R. In patient 2, the clinical score of the patient was improved from 15 to 10 after treatment with thymopentin. There was no difference in the serum IgE level. The ratio of Th/Ts was decreased after treatment. In vitro study, the production of IL-2, IL-3 and IL-4 were decreased in lymphocytes added with CsA and FK-506, but the production of sIL-2R was increased by CsA and FK-506. Also, the production of IL-3 and IL-4 were increased in lymphocytes added with thyrnopentin, but the proluction of IL-2 and sIL-2R were increased by thymopentin. Our data suggest that thymopentin could be effective in the treatment of severe AD through the upregulation of Thl-like subset, not via the downregulation of Th2-like subset.