Soluble CD30 and cyclosporine in severe atopic dermatitis

Background: Allergen-reactive Th2-like cells expressing membrane CD30 are p resent in the circulation of atopic dermatitis (AD) patients during seasona l allergen exposure. Moreover, CD30+ T cells are present in the lesional sk in of AD patients and high levels of soluble CD30 (sCD30) are found in the serum of the same atopic patients. To investigate the immunosuppressive cap acity of cyclosporin A (CsA) in AD patients, the sCD30 serum level was dete rmined before and after CsA treatment (5 mg/kg/day) in 10 patients with sev ere, refractory AD. The sCD30 serum levels before and after CsA therapy tog ether with other serum parameters were correlated with disease activity. Me thods: sCD30 serum levels were detected using a commercial sandwich ELISA; serum eosinophil cationic protein (ECP) levels were determined using a radi oimmunoassay (RIA). Results: In all AD patients sCD30 serum levels were inc reased ranging from 36 to 300 U/ml, with a mean value equal to 135.7 U/ml. After 6 weeks of CsA treatment, not only was there a significant difference between serum sCD30 levels before (mean 135.7) and after (mean 96.2) treat ment but even the serum ECP levels before (mean 57.78) and after (mean 18.6 9) therapy showed an important reduction. Moreover, no significant differen ce was found between the mean of serum IgE levels before and after treatmen t, although the values showed a correlation (p = 0.0003). No significant co rrelations could be demonstrated between sCD30 levels and serum IgE or betw een sCD30 and ECP serum levels nor between sCD30 levels and blood eosinophi l count after CsA treatment. Moreover, a positive correlation (p = 0.001) w as instead documented between sCD30 and the severity of the disease. Conclu sions: in this study, CsA therapy results in clinical improvement together with a statistically significant reduction in sCD30 and ECP serum levels in AD patients. Copyright (C) 2000 S. Karger AG, Basel.