Can We Repurpose FDA-Approved Alefacept to Diminish the HIV Reservoir?
BACKGROUND Sarcoidosis is a systemic granulomatous disease of unknown etiology that affects multiple organ systems, including the pulmonary, lymphatic, skeletal, and integumentary systems. Improved understanding of the intrinsic immunology and molecular biology in sarcoidosis can be applied to the treatment of this disease. Alefacept is a human fusion protein consisting of the extracellular domain of leukocyte function-associated antigen 3 fused with the Fc portion of human immunoglobulin G1. It works by blocking the interaction between antigen-presenting cells and T cells to inhibit activation and by inducing apoptosis of CD4+ T cells. In this case report, we describe a 46-year-old patient with recalcitrant lupus pernio who was successfully treated with alefacept. OBJECTIVE To determine whether T-cell inhibition, specifically the use of alefacept, may be used to treat a patient with recalcitrant cutaneous sarcoidosis. METHODS Case report. RESULTS There was a modest clinical improvement after 8 weeks of intramuscular injections of alefacept. CONCLUSION This case report provides further evidence of successful treatment of sarcoidosis with biologic agents directed against T-lymphocyte activation.