Abstract:

Objective To assess the changes in frequency of peripheral T lymphocytes expressing different cytokines in patients with atopic dermatitis （AD） before and after treatment with BCG-PSN and their relationship with disease severity. Methods A randomized, double blinded and placebo cross-over control study was conducted. A total of 8 patients with AD were recruited in this study. Intramuscular BCG-PSN or placebo was given to patients every other day for 36 days. Flow cytometry was performed to measure the frequency of IL4-, IL5-, IFNγ- and TNFα-expressing peripheral CD4+ T cells and CD8+ T cells before and after the therapy. Disease severity was evaluated by atopic dermatitis area and severity index score （ADASIS）. Results The difference value in IFN-γ+CD8+ T cell frequency before and after therapy was significantly higher in patients treated with BCG-PSN than in those with placebo （8.056 ± 13.962 vs -6.549 ± 10.491, U = 2.26, P < 0.05）. There was no statistical difference in the frequency of IL4-, IL5-, TNFα-expressing CD8+ T cells between BCG-PSN- and placebo-treated patients （all P > 0.05）. The decrease in ADASIS was 1.56 ± 1.49 in patients treated with BCG-PSN, which was statistically higher than that in placebo-treated patients （-0.05 ± 1.54, U = 2.00, P < 0.05）. Conclusion As an immunomodulator, BCG-PSN may control AD by restoring the balance of T-cell subsets.

Key words: atopic dermatitis, polysaccharide and nucleoside extract from Calmett- Guirin, cytokines