Er. Jarman et al., Inhibition of murine IgE and immediate cutaneous hypersensitivity responses to ovalbumin by the immunomodulatory agent leflunomide, CLIN EXP IM, 115(2), 1999, pp. 221-228
Leflunomide has been identified as an immunoregulatory and anti-inflammator
y compound. Allergic disease is characterized by elevated serum IgE levels,
production of allergen-specific IgE and the release of inflammatory mediat
ors from mast cells and granulocytes. Here we demonstrate, using an in vivo
murine model, the ability of leflunomide to down-regulate levels of total
and allergen-specific serum IgE production. Mice receiving leflunomide (45
mg/kg) orally at the time of primary immunization with ovalbumin adsorbed t
o aluminium hydroxide adjuvant, showed a reduction in total serum IgE level
s of 95%, 41% and 32% following primary, secondary and tertiary immunizatio
ns, respectively (P < 0.05). When leflunomide was administered both at the
time of primary and subsequent immunizations, reductions in total and speci
fic serum IgE levels of >80% and >38%, respectively, were observed (P < 0.0
5). Administration of leflunomide to mice which had already developed an Ig
E response resulted in reductions in total and specific serum IgE levels of
>80% and >45%, respectively (P < 0.05). Following leflunomide treatment, a
nimals failed to develop immediate cutaneous hypersensitivity responses whe
n challenged intradermally with allergen. Down- regulation of immunoglobuli
n production was not restricted to IgE, since levels of allergen-specific I
gG1 and IgG2a in serum were also reduced. The finding of significant reduct
ions in total and allergen-specific IgM suggests that the mechanism of acti
on does not involve selective inhibition of immunoglobulin class switching.
A loss in production of the T helper cell-derived B cell differentiation f
actor IL-5 may account for the reduction in immunoglobulin levels. In adopt
ive transfer experiments leflunomide did not induce tolerance in allergen-r
eactive Th2 populations, contrary to animal disease models of transplantati
on and autoimmunity, where leflunomide was shown to induce tolerance in the
effector T cell population.