CD4 MONOCLONAL-ANTIBODY ADMINISTRATION IN ATOPIC-DERMATITIS

Background: Atopic dermatitis (AD) is a chronic inflammatory dermatosi s that probably involves a dysregulated activation of helper T cells, type 2 (Th2 cells). Severe refractory AD can be controlled by cyclospo rine treatment. Objective: We attempted to determine whether short-ter m CD4 monoclonal antibody (mAb) therapy could improve severe AD in adu lts. Methods. The CD4 mAB, B-F5, was infused over 2 days in three pati ents with severe refractory AD and for control purposes, in two patien ts with severe psoriasis. Results: Administration of B-F5 was well tol erated, despite moderate first dose side effects. Clinical improvement was observed in two patients. In the third patient, a dramatic worsen ing occurred between 8 and 30 days after treatment, associated with an increased percentage of activated CD4(+), CD25(+), HLA-DR(+), and CD4 5RO(+) cells and peripheral blood eosinophilia. The same CD4 mAb admin istered to two patients with severe psoriasis induced marked clinical improvement of the lesions, Conclusion: Although CD4 mAb infusion may be potentially useful in the treatment of AD, the risk of aggravating the Th1/Th2 imbalance in AD should be considered in the design of futu re protocols.