Originaltexte aus dem Archiv der Universität Erlangen

[Treatment of atopic dermatitis with borage seed oil (Glandol)--a time series analytic study] Bahmer-FA; Schafer-J Kinderarztl-Prax.1992 Oct; 60(7): 199-202.

The therapy of atopic dermatitis with highly unsaturated fatty acids has witnessed a renaissance in the last years. Therefore, a study was conducted with borage oil (Glandol), rich in highly unsaturated, so-called omega fatty acids, against palm seed oil as placebo in a total of 12 patients. Evaluation of the severity of the skin changes was done by means of the ADASI (Atopic Dermatitis Area and Severity Index)-score system described by us recently. The ADASI-scores, forming a time series, were analyzed by trend analysis methods. These methods allow an evaluation of the effectiveness of the therapy in each case. The analysis revealed that five out of seven patients treated with borage oil showed a favourable effect with regard to the skin changes assessed by the ADASI-score. In contrast, only one out of the five patients treated with placebo showed a significant improvement in skin changes. In view of the positive effect ob borage oil in patients with atopic dermatitis, a trial therapy for a certain period seems justified. Our study demonstrates both the value of our ADASI-scoring system as well as the advantages that time series or trend analysis methods might have for the evaluation of therapeutic effects in chronic skin diseases such as atopic dermatitis.

The efficacy and safety of gamma-linolenic acid in the treatment of infantile atopic dermatitis. Fiocchi-A; Sala-M; Signoroni-P; Banderali-G; Agostoni-C; Riva-E J-Int-Med-Res.1994 Jan-Feb; 22(1): 24-32.

The efficacy and safety of gamma-linolenic acid in the treatment of atopic dermatitis was evaluated. The children (mean age, 11.4 months) with atopic dermatitis (mean duration, 8.56 months) were openly treated with 3 g/day gamma-linolenic acid, for 28 days.
Clinical evaluations were carried out every 7 days, and parents were asked to keep a diary, recording details of symptoms of eczema every day. Blood chemistry and immunological tests were done before and after treatment. None of the children showed complete recovery of symptoms. A gradual improvement in erythema, excoriations and lichenification was seen; significant differences were shown for itching (P < 0.01), and the use of antihistamines (P < 0.01). A significant rise in the percentage of circulating CD8 was found. No side-effects were recorded. Dietetic and pharmacological approaches are the basis of the treatment of atopic dermatitis and gamma-linolenic acid appears to be a safe and efficient additional therapy for infants and young children.

Epogam evening primrose oil treatment in atopic dermatitis and asthma. Hederos-CA; Berg-A Arch-Dis-Child.1996 Dec; 75(6): 494-7.

Essential fatty acids are claimed to have positive effects in atopic diseases. In a doubleblind, placebo controlled, parallel group study 58 out of 60 children, with atopicdermatitis and the need for regular treatment with topical skin steroids, completed a 16 weeks' treatment period with either Epogam evening primrose oil or placebo capsules.
Twenty two of these subjects also had asthma. The parents used diaries to record symptom scores and concomitant medication. Peak expiratory flow was measured and disease activity was monitored by the clinician every four weeks. The plasma concentrations of essential fatty acids increased significantly in the group treated with Epogam capsules. The study demonstrated significant improvements of the eczema symptoms but no significant difference was found between the placebo and the Epogam groups. No therapeutic effect was shown on asthma symptoms or fidget.

Treatment of atopic eczema with evening primrose oil: rationale and clinical results.
Kerscher-MJ; Korting-HC Clin-Investig.1992 Feb; 70(2): 167-71.

Recently a defect in the function of the enzyme delta-6-desaturase has been discussed as a major factor in the development of atopic eczema. Delta-6-desaturase is responsible for the conversion of linoleic acid to gamma linolenic acid. Several plants, including evening primrose, are known to be fairly rich in gamma linolenic acid. Hence, substitution of gamma linolenic acid in patients prone to developing atopic eczema seems like a feasible concept. During the last few years different clinical trials have been performed. Controlled trials following a parallel study design showed marked improvement in atopic eczema. Patients treated with the drug showed less inflammation, dryness, scaling and overall severity compared to controls.
Although these findings have been supported by meta-analysis, there is still conflicting evidence in trials based on a crossover design alone, demonstrating a decrease in itching. At present, evening primrose oil in doses used for the treatment of atopic eczema is considered safe. However, still more trials addressing both efficacy and safety are needed to make a final decision.

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