Novel immunological approaches in the treatment of atopic eczema.

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Novel immunological approaches in the treatment of atopic eczema.
Belloni B, Andres C, Ollert M, Ring J, Mempel M.

Department of Dermatology and Allergy, Technische Universität München, München, Germany.

PURPOSE OF REVIEW: Atopic eczema is a common inflammatory skin disease showing chronically relapsing eczema and high association with elevated serum IgE levels. A subgroup of atopic eczema patients requires systemic immunomodulatory treatment for long time periods. However, beyond cyclosporine A and azathioprine, only limited consent exists on systemic treatment options. RECENT FINDINGS: Timely published systemic treatment modalities include studies on efalizumab (anti-CD11a antibody), infliximab, adalimumab, and etanercept (anti-TNF-alpha treatment), omalizumab (an anti-IgE antibody), rituximab (an anti-CD20 antibody), specific immunotherapy, leflunomide, and leukotriene receptor antagonists with varying clinical results and with particular safety profiles. SUMMARY: Although there is not yet a treatment modality reaching clinical efficacy of cyclosporine A as gold standard of systemic therapy, limitation in its application duration as in its side effect profile as well as the search for alternatives has set a focus on the new alternatives of which especially B-cell-directed therapies might be promising candidates.


Curr Opin Allergy Clin Immunol. 2008 Oct;8(5):423-7.