Ong Peck Y
Department of Pediatrics, Keck School of Medicine, University of Southern California, Childrens Hospital Los Angeles, Division of Clinical Immunology and Allergy, Los Angeles, California 90027, USA.
Expert Opin Emerg Drugs. 2009 Mar;14(1):165-79. doi: 10.1517/14728210902721248.
Atopic dermatitis (AD) is the most common chronic inflammatory skin disease, affecting 10-20% of children and 2% of adults worldwide. Preventive treatment of AD consists of daily skin hydration and emollient therapy; but the majority of patients still require symptomatic treatment with topical corticosteroids and/or topical calcineurin inhibitors, both of which may be associated with potential long-term side effects. With increasing evidence supporting the role of skin barrier defects in the pathogenesis of AD, there is also a parallel increase in medications that claim to assist barrier repair. The current review discusses some exciting results with these medications, as well as the challenges that lie ahead of them. While barrier repair treatments offer some promise, there continues to be a need for safer anti-inflammatory medications. Some of these medications under investigation are phosphodiesterase-4 inhibitors, urocanic acid oxidation products and IL-4/IL-13 receptor blockers. The review also discusses anti-staphylococcal treatments including nanocrystalline silver cream, silver and antimicrobial-coated fabrics, and anti-itch treatments including mu-opiod receptor antagonists, chymase inhibitors and cannabinoid receptor agonists. These medications may become an integral part of AD therapy.
特应性皮炎（AD）是最常见的慢性炎症性皮肤病，全球10%-20%的儿童及2%的成年人受其影响。AD的预防性治疗包括每日皮肤保湿和润肤剂治疗；但大多数患者仍需要使用外用糖皮质激素和/或外用钙调神经磷酸酶抑制剂进行对症治疗，这两种药物都可能有潜在的长期副作用。随着越来越多的证据支持皮肤屏障缺陷在AD发病机制中的作用，宣称有助于屏障修复的药物也相应增加。本综述讨论了这些药物取得的一些令人振奋的成果以及它们面临的挑战。虽然屏障修复治疗有一定前景，但仍需要更安全的抗炎药物。一些正在研究的此类药物有磷酸二酯酶-4抑制剂、尿刊酸氧化产物和IL-4/IL-13受体阻滞剂。本综述还讨论了抗葡萄球菌治疗，包括纳米晶银霜、镀银及抗菌织物，以及止痒治疗，包括μ-阿片受体拮抗剂、糜酶抑制剂和大麻素受体激动剂。这些药物可能会成为AD治疗的重要组成部分。
