An unexpected increase in circulating IFN-gamma by cyclosporin A in atopic patients: a discrepancy between in vitro and in vivo events.
Shiohara T, Sagawa Y, Nagashima M
Defective interferon gamma (IFN-gamma) production has been suggested to be relevant to immunologic abnormalities observed in atopic dermatitis (AD). We describe two patients with severe AD who were treated with oral cyclosporin A (Cy-A) and in whom the serum levels of IL-1 alpha, IFN-gamma and tumor necrosis factor alpha (TNF-alpha) were sequentially measured. Cy-A, known to inhibit IFN-gamma production in vitro, caused a rapid rise in serum IFN-gamma, but not Il-1 alpha and TNF alpha, levels in the patients and the IFN-gamma levels appeared to be inversely related to the therapeutic efficacy. The observed increase in serum IFN-gamma levels during Cy-A therapy may have contributed to a marked clinical improvement of the AD.