Skip to main content

Advertisement

SpringerLink
Log in

Effects of Oral Bacterial Immunotherapy in Children with Atopic Eczema/Dermatitis Syndrome

A Pilot Study

  • Short Communication
  • Published:
BioDrugs Aims and scope Submit manuscript

Abstract

Background

Atopic eczema/dermatitis syndrome (AEDS) is a chronic inflammatory skin disease, affecting 10–20% of children and 1–3% of adults. The purpose of this pilot study was to assess the clinical and anti-inflammatory effect of bacterial and ribosomal immunotherapy with Immucytal® (Pierre Fabre Médicament, France) in children with AEDS.

Methods

Seventeen children with allergic and non-allergic forms of AEDS (AAEDS and NAAEDS, respectively), graded moderate to severe (Severity Scoring of Atopic Dermatitis [SCORAD] index of >25), received ribosomal immunotherapy (Immucytal®) once daily according to the standard treatment regimen (4 consecutive days a week for 3 weeks, and then 4 consecutive days a month for 4 months). We assessed the clinical status of AEDS using the SCORAD index at baseline, and after 8 and 20 weeks of treatment. Furthermore, peripheral blood from patients was examined for the frequencies of CD4+ cells expressing interferon (IFN)-ψ and interleukin (IL)-4 using flow cytometry.

Results

There was a progressive and significant clinical improvement of AEDS, confirmed by a reduction of the SCORAD index over time in both AEDS forms (p < 0.01). Pooled data from the two groups showed that the mean baseline index of 43 was reduced to 17 after treatment. Overall, these data indicate a marked improvement in total clinical severity of AEDS (−62%). Flow cytometry analysis showed that frequencies of the two CD4+ T cell subsets did not differ significantly from the beginning to the end of the study in both forms of AEDS. However, the percentage of CD4+ cells expressing IL-4 in children with AAEDS tended to decrease by the end of treatment with ribosomal immunotherapy. Clinical and laboratory data confirmed that immunotherapy was well tolerated.

Conclusions

The results of this pilot investigation suggest that ribosomal immunotherapy may be beneficial in the management of AEDS in children, and that this could be at least partially explained by a role in restoring the type 2 helper-T cell imbalance seen in allergic patients. Placebo-controlled, randomized clinical trials are recommended in order to confirm these findings.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Table I
Fig. 1
Table II
Fig. 2
Fig. 3

Notes

  1. The use of trade names is for product identification purposes only and does not imply endorsement.

References

  1. Leung DYM, Bieber T. Atopic dermatitis. Lancet 2003; 361(9352): 151–60

    Article  PubMed  Google Scholar 

  2. Schultz-Larsen F, Hanifin JM. Epidemiology of atopic dermatitis. Immunol Allergy Clin North Am 2002; 22: 1–24

    Article  Google Scholar 

  3. Bardana Jr EJ. Immunoglobulin E-(IgE) and non-IgE-mediated reactions in the pathogenesis of atopic eczema/dermatitis syndrome (AEDS). Allergy 2004; 59Suppl. 78: 25–9

    Article  PubMed  CAS  Google Scholar 

  4. Romagnani S. The role of lymphocytes in allergic disease. J Allergy Clin Immunol 2000; 105: 399–408

    Article  PubMed  CAS  Google Scholar 

  5. Strachan DP. Hay fever, hygiene, and household size. BMJ 1989; 299(6710): 1259–60

    Article  PubMed  CAS  Google Scholar 

  6. Gibbs S, Surridge H, Adamson R, et al. Atopic dermatitis and the hygiene hypothesis: a case-control study. Int J Epidemiol 2004; 33(1): 199–207

    Article  PubMed  Google Scholar 

  7. Roll A, Cozzio A, Fischer B, et al. Microbial colonization and atopic dermatitis. Curr Opin Allergy Clin Immunol 2004; 4: 373–8

    Article  PubMed  Google Scholar 

  8. Clot J. Pharmacology of ribosomal immunotherapy. Drugs 1997; 54Suppl. 1: 33–6

    Article  PubMed  CAS  Google Scholar 

  9. Revillard JP, Millet I, Lafont S, et al. In vitro cell activating properties of the composite ribosomal vaccine D53. Intern Symp Immunomodulators 1987; 82Suppl. II: 173–8

    Google Scholar 

  10. Bowman LM, Holt PG. Selective enhancement of systemic Th1 immunity in immunologically immature rats with an orally administered bacterial extract. Infect Immun 2001; 69(6): 3719–27

    Article  PubMed  CAS  Google Scholar 

  11. Bellanti JA, Olivieri D, Serrano E. Ribosomal immunostimulation. BioDrugs 2003; 17(5): 355–67

    Article  PubMed  CAS  Google Scholar 

  12. Hanifin JM, Rajka G. Diagnostic features of atopic dermatitis. Acta Derm Venereol 1980; 92: 44–7

    Google Scholar 

  13. Consensus report of the European Task Force on Atopic Dermatitis. Severity scoring of atopic dermatitis: the SCORAD index. Dermatology 1993; 186: 23–31

    Article  Google Scholar 

  14. Allavena P, Erroi A, Pirelli A, et al. Stimulation of cytotoxic and non-cytotoxic functions of natural killer cells by bacterial membrane proteoglycans and ribosomes. Int J Immunopharmacol 1989; 11(1): 29–34

    Article  PubMed  CAS  Google Scholar 

  15. Murch SH. Toll of allergy reduced by probiotics. Lancet 2001; 357(9262): 1057–9

    Article  PubMed  CAS  Google Scholar 

  16. Kalliomaki M, Kirjavainen P, Eerola E, et al. Distinct patterns of neonatal gut microflora in infants in whom atopy was and was not developing. J Allergy Clin Immunol 2001; 107(1): 129–34

    Article  PubMed  CAS  Google Scholar 

  17. Duramad P, McMahon CW, Hubbard A, et al. Flow cytometric detection of intracellular TH1/TH2 cytokines using whole blood: validation of immunologic biomarker for use in epidemiologic studies. Cancer Epidemiol Biomarkers Prev 2004; 13(9): 1452–8

    PubMed  CAS  Google Scholar 

  18. Oppenheim JJ, Kovacs EJ, Matsushima K, et al. There is more than one interleukin 1. Immunol Today 1986; 7(2): 45–56

    Article  CAS  Google Scholar 

  19. Lafont S, Iwaz J, Cozon G, et al. Production d’interleukine-1 par les monocytes sanguins et les macrophages pulmonaires stimules par les composants de D53 (Ribomunyl®). Med Mal Infect 1988; 8/9: 355–9

    Article  Google Scholar 

  20. Pujol J-L, Klein B, Godard P, et al. Bacterial ribosomal immunostimulants prime alveolar macrophages in vivo to produce interleukin 1 in vitro. Chest 1991; 100(3): 644–8

    Article  PubMed  CAS  Google Scholar 

  21. Nozaki S, Feliciani C, Sauder DN. Keratinocyte cytokines. Adv Dermatol 1992; 7: 83–100

    PubMed  CAS  Google Scholar 

  22. Murphy J-E, Robert C, Kupper TS. Interleukin-1 and cutaneous inflammation: a crucial link between innate and acquired immunity. J Invest Dermatol 2000; 114: 602–8

    Article  PubMed  CAS  Google Scholar 

  23. Hamid Q, Boguniewicz M, Leung DY. Differential in situ cytokine gene expression in acute versus chronic atopic dermatitis. J Clin Invest 1994; 94: 870–6

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

Luigia Brunetti and Ruggiero Francavilla contributed equally to the work. The authors have no conflicts of interest relevant to the contents of this manuscript and have received no funding or assistance with regard to this study. No collaborators other than the authors were involved in the preparation of this manuscript. This paper is an accurate representation of the study results.

Author information

Authors and Affiliations

  1. Department of Pediatrics, Division “S. Maggiore”, University of Bari, Bari, Italy

    Luigia Brunetti, Riccardina Tesse, Patrizia Fiermonte, Mariacristina Massagli & Lucio Armenio

  2. Department of Pediatrics, Division “B. Trambusti”, University of Bari, Bari, Italy

    Ruggiero Francavilla

  3. Department of Clinical Medicine, Immunology, and Infectious Diseases, University of Bari, Bari, Italy

    Porzia Dambra & Maria P. Loria

  4. Clinica Pediatria I, Policlinico di Bari, P.zza G. Cesare 11, 70124, Bari, Italy

    Luigia Brunetti

Authors
  1. Luigia Brunetti
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ruggiero Francavilla
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Riccardina Tesse
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Patrizia Fiermonte
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Porzia Dambra
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Mariacristina Massagli
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Maria P. Loria
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Lucio Armenio
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Luigia Brunetti.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Brunetti, L., Francavilla, R., Tesse, R. et al. Effects of Oral Bacterial Immunotherapy in Children with Atopic Eczema/Dermatitis Syndrome. BioDrugs 19, 393–399 (2005). https://doi.org/10.2165/00063030-200519060-00006

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.2165/00063030-200519060-00006

Keywords

Search

Navigation