Methods: Sixteen adult patients with severe AD sensitized to house dust (HDM) mite were treated by intramuscular injections of 50 mg autologous immunoglobulin (mainly IgG with purity ≥ 97%) twice a week for 4 weeks. Autologous immunoglobulin was purified from autologous plasma by affinity chromatography using Protein A. The serum concentrations of total IgE, specific IgE to Dermatophagoides farinae (D. farinae), and specific IgE to recombinant Der f 2 (rDer f 2) at baseline, 4, 8, and 12 weeks were measured using enzyme-linked immunosorbent assay.
Results: The serum concentrations of total IgE significantly decreased from 25678.9 ± 22826.4 kU/L (mean ± SD) at baseline to 22361.4 ± 23020.4 kU/L at 4 weeks, 21306.1 ± 20585.7 kU/L at 8 weeks, and 18143.8 ± 16852.4 kU/L at 12 weeks (Wilcoxon signed-rank test, P < 0.05).The serum concentrations of specific IgE to D. farinae significantly decreased from 503.3 ± 885.5 kU/L at baseline to 282.1 ± 415.7 kU/L at 4 weeks, 227.8 ± 378.7 kU/L at 8 weeks, and 191.7 ± 294.2 kU/L at 12 weeks (P < 0.05). The serum concentrations of specific IgE to rDer f 2 significantly decreased from 47.9 ± 47.6 kU/L at baseline to 34.4 ± 35.5 kU/L at 8 weeks, 30.2 ± 28.0 kU/L at 12 weeks (P < 0.05).
Conclusions: Repeated intramuscular injections of autologous immunoglobulin significantly decreased serum concentrations of total IgE and allergen-specific IgE antibodies in patients with severe AD.
Reference
Nahm DH, Cho SM, Kim ME, Kim YJ, Jeon SY. Autologous immunoglobulin therapy in patients with severe recalcitrant atopic dermatitis: a preliminary report. Allergy Asthma Immunol Res 2014;6:89-94