伊曲康唑治疗特应性皮炎的疗效及机制

The effect and mechanism on treating atopic dermatitis with Itraconazole

目的探讨伊曲康唑治疗特应性皮炎(AD)的疗效及机制。方法将23例AD患者分为治疗组(15例)和对照组(8例),分别给予伊曲康唑和氯雷他定,疗程为15 d。检测治疗前、后白介素(IL)-4、IL-5、IL-13、IL-2、IL-12、γ干扰素(INF-γ)、血清总IgE、外周血嗜酸细胞绝对计数(EOS)并进行临床评分。结果治疗组治疗后的细胞内和血清IL-5、IL-4、IL-13均显著低于治疗前(P值均<0．05),而细胞内IL-12、IFN-γ较治疗前略有升高,但差异无统计学意义(P值均>0．05);治疗组治疗后总IgE、EOS、临床症状评分也显著低于治疗前(P值均<0．001)。而对照组治疗前、后细胞内IL-4、IL-5、IL-13、IL-2、IL-12、IFN-γ及血清IL-4、IL-5、IL-13、EOS的差异均无统计学意义(P值均>0．05),但总IgE、临床症状积分较治疗前显著下降(P值均<0．05)。结论伊曲康唑治疗AD有效,其机制可能与降低辅助性T细胞(Th)2型细胞因子、提高Th1型细胞因子有关。

Objective To study the effect and mechanism of using Iraconazole for treating atopic dermatitis. Methods Twenty three patients were enrolled and divided into two groups, the treated group and control group. Fifteen patients in the treated group took Itraconazole 200 mg per day, whereas eight patients in the control group took Loratadine 10 mg once a day; both were individually. Two weeks afterward, IL-4, IL-5, IL-13 IL-2, IL-12 and IFN-γ were tested by FACS analysis. While, the serum cytokines and IgE were checked with ELISA, including the check of peripheral eosinophil cells （EOS）. Results In the treated group, IL-5, IL-4 and IL-13 decreased with increase of IL-12 and IFN-γ; whereas the serum IgE, EOS count and the clinical score were lower than those before treatment. In control group, there were no statisticed differences in the serum cytokines and EOS counts after Loratadine, but serum IgE and the clinical score decreased. Conclusion Itraconazole is effective in atopic dermatitis. Its mechanism may due to decrease of type Th2 cytokines, and increase of type 1 cytokines.