Document Detail


The comparative effects of tacrolimus and hydrocortisone in adult atopic dermatitis: an immunohistochemical study.
MedLine Citation:
PMID:  17223872     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: While many studies have demonstrated the efficacy and safety of tacrolimus ointment in the treatment of atopic dermatitis (AD), only a few have investigated the effects of tacrolimus on inflammatory cells and their cytokine gene expression in patients with AD. OBJECTIVES: To characterize further the immunophenotype of infiltrating cells and the production of certain cytokines before and after treatment with topical tacrolimus and hydrocortisone butyrate. METHODS: Nine adult patients with moderate to severe AD were treated with tacrolimus ointment, while seven control patients were treated with hydrocortisone butyrate ointment. We performed lesional skin biopsies before and after treatment. These were stained immunohistochemically with a panel of monoclonal antibodies including those to CD1a, CD3, CD4, CD8, myeloperoxidase, EG1, EG2, tryptase, interferon-gamma, interleukin (IL)-4, IL-5, IL-12, IL-13, receptors for CXC chemokines (CXCR) 3 and 4, and receptor 3 for CC chemokines. RESULTS: CD3+, CD4+ and CD8+ lymphocytes, and eosinophil and neutrophil granulocytes were significantly reduced in post-treatment tacrolimus specimens, while CD1a+ cells and mast cells were not. The expression of cytokines and chemokine receptors tested, except for CXCR3, was diminished by tacrolimus treatment. Moreover, tacrolimus produced a greater reduction of lymphocytes, eosinophils and most cytokines than that induced by hydrocortisone butyrate. CONCLUSIONS: Tacrolimus not only inhibits T-lymphocyte proliferation and cytokine production, but also plays an important role in the IL-12-induced shift from a T-helper (Th) 2 to a Th1 cytokine profile that characterizes the development of chronic AD. Tacrolimus also demonstrates wider pharmacodynamic effects than hydrocortisone.
Authors:
M Caproni; D Torchia; E Antiga; M Terranova; W Volpi; E del Bianco; A D'Agata; P Fabbri
Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  The British journal of dermatology     Volume:  156     ISSN:  0007-0963     ISO Abbreviation:  Br. J. Dermatol.     Publication Date:  2007 Feb 
Date Detail:
Created Date:  2007-01-16     Completed Date:  2007-06-25     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0004041     Medline TA:  Br J Dermatol     Country:  England    
Other Details:
Languages:  eng     Pagination:  312-9     Citation Subset:  IM    
Affiliation:
Department of Dermatological Sciences, University of Florence, Via della Pergola 58/60, 50121 Florence, Italy.
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MeSH Terms
Descriptor/Qualifier:
Administration, Topical
Adult
Aged
Antibodies, Monoclonal / diagnostic use
Cytokines / metabolism*
Dermatitis, Atopic / drug therapy*,  metabolism
Female
Humans
Hydrocortisone / therapeutic use*
Immunohistochemistry
Immunosuppressive Agents / therapeutic use*
Male
Middle Aged
Ointments
Receptors, Cytokine / metabolism
Tacrolimus / therapeutic use*
Treatment Outcome
Chemical
Reg. No./Substance:
0/Antibodies, Monoclonal; 0/Cytokines; 0/Immunosuppressive Agents; 0/Ointments; 0/Receptors, Cytokine; 109581-93-3/Tacrolimus; 50-23-7/Hydrocortisone

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