The pathogenesis 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 active pentapepide of a thymic hormone, promotes differentiation of thymocytes and exhibits immunomodulating function.
We experienced 2 cases 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 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. The 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 I 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 lymphooytes added with
thymopentin, but the production fo IL-2 and sIL02R were incrreased by thymopentin.
Our data suggest that thymopentin could be effective in the treatment of severe AD through the upregulation of Th1-like subset, not via the downreguation of Th2-like subset.
(Kor J Dermatol 1996;34(4) : 668~672)
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