IGHE and Alzheimer disease: In a BALB/c AD mouse model, a 0.1% piperine ethosomal cream reduced ear/skin thickness, clinical severity scores, leukocytes, granulocytes, and serum IgE significantly vs. vehicle and vs. a matched conventional piperine cream (0.125%) and showed greater overall efficacy than 0.1% tacrolimus ointment (head-to-head in the same model) [30].