アトピー性皮膚炎患者における末梢血単核細胞の免疫抑制薬感受性と黄色ブドウ球菌由来スーパー抗原抗体価との関連
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Staphylococcus aureus (S. aureus) producing superantigens (SAgs), such as staphylococcal enterotoxin B (SEB) and toxic shock syndrome toxin-1 (TSST-1) are frequently observed in atopic dermatitis (AD). However, few studies have been carried out to disclose the association of immune responses to SAgs and the therapeutic response to immunosuppressive drugs in AD. Therefore, we investigated the prevalence and role of SAgs on the pathophysiology and immunosuppressive drug-sensitivity in AD patients. We classified 29 patients into two groups on the basis of their clinical AD scores : the low-score group (n=14) corresponding to mild patients and the high-score group (n=15) corresponding to severe patients. We analyzed the plasma anti-SEB-or TSST-1-IgE level of these patients and healthy subjects by ELISA. We estimated individual drug-sensitivity by determining the drug concentrations that would give 50% inhibition (IC50) of peripheral blood mononuclear cell (PBMC) proliferation in vitro. The levels of plasma anti-SEB- and TSST-1-IgE in the severe patients were significantly higher than those in the mild patients (p<0.05 and p<0.05, respectively). When stimulated with concanavarin A (ConA) in vitro, PBMCs in the severe patients exhibited a low sensitivity to suppressive efficacy of tacrolimus as compared to the mild patients (p<0.01). Furthermore, there was a significant correlation between the IC50s of tacrolimus and plasma anti-TSST-1-IgE levels (p<0.01). We showed that PBMCs in severe AD patients exhibited a lower sensitivity to tacrolimus, and had higher plasma levels of anti TSST-1-IgE as compared to mild AD patients. SAgs appear to be one of the causes of decreased PBMC sensitivity to tacrolimus, and therefore, alternative treatment might be useful if considered according to the individual drugsensitivity data and anti-TSST-1 IgE levels.
- 一般社団法人 日本臨床薬理学会の論文
一般社団法人 日本臨床薬理学会 | 論文
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