Specific immunotherapy for atopic dermatitis

The pathogenesis of atopic dermatitis is still unclear, despite extensive progress recently made in this area. However, many arguments confirm that an immune reaction against environmental allergens play a predominant role, either by triggering the reaction or in exacerbations of the disease. Specific immunotherapy therefore has an important role. The authors have used the capacity of specific antibodies to modulate their own synthesis, either by induction of anti-idiotype antibodies, or by modulation of antigen presentation. Specific anti-allergen antibodies were prepared and used to form complexes with the corresponding allergern. They were consequently able to define the basis for treatment, which was subsequently used in the context of several clinical trials, demonstrating an obvious clinical efficacy which persisted in the longterm for some patients. The main associated laboratory changes consisted of a reduction of circulating specific IgE and IgG antibody levels and increased levels of the corresponding anti-idiotype antibodies. The perspectives of application of this treatment to a greater number of patients are discussed, together with several fundamental research appearances.