Meykadeh N, Hengge U R
Klinik für Dermatologie, Heinrich-Heine-Universität, Düsseldorf.
Hautarzt. 2003 Jul;54(7):641-61; quiz 662. doi: 10.1007/s00105-003-0556-8.
Immunomodulators include both immunostimulatory and immunosuppressive agents. Obligate contact sensitizers such as diphencyprone or dinitrochlorobenzene have been used against viral and autoimmune diseases. Newer agents such as the toll-like receptor agonists imiquimod and resiquimod have been clinically used to treat viral infections and skin cancers in immunocompetent and immunosuppressed patients. On the other hand, the topical immunosuppressive agents tacrolimus and pimecrolimus have been used with great success in the treatment of chronic inflammatory diseases in children and adults. The introduction of this new class of drugs (i.e. Calcineurin inhibitors) marked the beginning of the post-cortisone era in clinical dermatology. Toll-like receptor agonists and calcineurin antagonists will supplement corticosteroids to improve specific dermatological therapy. Topical immunotherapy with both immunostimulatory and immunosuppressive agents show potential for effective and patient-friendly treatment of inflammatory, infectious and neoplastic skin diseases. Long-term evaluation will define the tolerability and the safety profile.
免疫调节剂包括免疫刺激剂和免疫抑制剂。诸如二苯环丙烯酮或二硝基氯苯之类的专性接触致敏剂已被用于对抗病毒和自身免疫性疾病。新型药物如Toll样受体激动剂咪喹莫特和瑞喹莫特已在临床上用于治疗免疫功能正常和免疫抑制患者的病毒感染及皮肤癌。另一方面，局部免疫抑制剂他克莫司和吡美莫司已成功用于治疗儿童和成人的慢性炎症性疾病。这类新型药物（即钙调神经磷酸酶抑制剂）的引入标志着临床皮肤科后皮质类固醇时代的开始。Toll样受体激动剂和钙调神经磷酸酶拮抗剂将补充皮质类固醇以改善特定的皮肤病治疗。使用免疫刺激剂和免疫抑制剂的局部免疫疗法显示出有效且对患者友好地治疗炎症性、感染性和肿瘤性皮肤病的潜力。长期评估将确定其耐受性和安全性。
