INTERFERON-GAMMA FOR TREATMENT OF SEVERE ATOPIC ECZEMA IN 2 CHILDREN

Two 4- and 5-year-old children suffering from refractory atopic dermat itis were treated with recombinant interferon-gamma (rIFN-gamma). rIFN -gamma was injected at 50 mu g subcutaneously three times a week in th e first child for 3 weeks, followed by three times 25 mu g in week 4. In the other child two treatment courses of 4 weeks were given after a break of 2 weeks. Therapy was well tolerated. In child one reductions in eczematous body surface and severity of lesions were observed, whi le no beneficial effect was seen in the other. Clinical chemistry data remained unchanged. Immunological studies performed in parallel showe d a decrease in total serum IgE of 50% in child 1, a decrease in spont aneous in vitro IgE production, an increase in in vitro production of interleukin-6, and a normalization of previously decreased in vitro ly mphocyte responses to several mitogens. While marked immunological cha nges were noted during IFN-gamma treatment, clinical benefits were not encouraging. Diminished IFN-gamma production has been claimed to be a major pathogenic factor in atopic eczema. Our results indicate that t he pathogenesis is more complex. Clinically, we were unable to confirm previous observations in adults. Further studies are needed before IF N-gamma can be recommended for therapy of pediatric atopic eczema.