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[特应性皮炎系统治疗的现状与前景。生物制剂即将问世]

[Status quo and prospects for systemic therapy of atopic dermatitis. Biologics ante portas].

作者信息

Biedermann T, Werfel T

机构信息

Klinik und Poliklinik für Dermatologie und Allergologie, Biedersteinerstraße 29, 80802, München, Deutschland.

出版信息

Hautarzt. 2015 Feb;66(2):108-13. doi: 10.1007/s00105-014-3575-8.

DOI:10.1007/s00105-014-3575-8
PMID:25645542
Abstract

Currently the only approved drug available for the systemic therapy of atopic dermatitis is cyclosporine; however, based on current data from published studies, azathioprine, methotrexate, and mycophenolate mofetil or mycophenolic acid can be administered off-label. Some biologics on the market that have been approved for other indications (ustekinumab, rituximab, tocilizumab) have been successfully used in a few patients with atopic dermatitis. The world's first prospective controlled studies with the biologic human anti-IL4R antibody dupilumab for the indication "atopic dermatitis" were published in 2014. These motivated (1) to extend the studies to dupilumab and (2) to clinically test antagonization of other target molecules of TH2 polarized, atopic inflammation, e.g., IL-13, IL-31, IL-22, TSLP, and CRTH2. A number of clinical trials are currently recruiting in this area and will provide interesting new insights for future therapeutic approaches in atopic dermatitis.

摘要

目前,唯一被批准用于特应性皮炎全身治疗的药物是环孢素;然而,根据已发表研究的现有数据,硫唑嘌呤、甲氨蝶呤以及霉酚酸酯或霉酚酸可在无获批适应症的情况下使用。市场上一些已被批准用于其他适应症的生物制剂(乌司奴单抗、利妥昔单抗、托珠单抗)已成功用于少数特应性皮炎患者。2014年发表了世界上首例关于生物制剂人抗IL4R抗体度普利尤单抗用于“特应性皮炎”适应症的前瞻性对照研究。这些研究促使(1)将研究扩展至度普利尤单抗,以及(2)对TH2极化的特应性炎症的其他靶分子(如IL-13、IL-31、IL-22、TSLP和CRTH2)的拮抗作用进行临床试验。目前该领域有多项临床试验正在招募受试者,这将为特应性皮炎未来的治疗方法提供有趣的新见解。

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引用本文的文献

1
Spotlight on dupilumab in the treatment of atopic dermatitis: design, development, and potential place in therapy.度普利尤单抗治疗特应性皮炎的聚焦:设计、研发及在治疗中的潜在地位
Drug Des Devel Ther. 2017 May 15;11:1473-1480. doi: 10.2147/DDDT.S113192. eCollection 2017.

本文引用的文献

1
Dupilumab improves the molecular signature in skin of patients with moderate-to-severe atopic dermatitis.度普利尤单抗可改善中重度特应性皮炎患者的皮肤分子特征。
J Allergy Clin Immunol. 2014 Dec;134(6):1293-1300. doi: 10.1016/j.jaci.2014.10.013.
2
Novel investigational therapies for atopic dermatitis.特应性皮炎的新型研究性疗法。
Expert Opin Investig Drugs. 2015 Jan;24(1):61-68. doi: 10.1517/13543784.2015.957756. Epub 2014 Sep 9.
3
Off-label prescriptions for atopic dermatitis in Europe.在欧洲针对特应性皮炎的标签外处方。
Allergy. 2015 Jan;70(1):6-11. doi: 10.1111/all.12498. Epub 2014 Sep 4.
4
Dupilumab treatment in adults with moderate-to-severe atopic dermatitis.度普利尤单抗治疗中重度特应性皮炎成人患者。
N Engl J Med. 2014 Jul 10;371(2):130-9. doi: 10.1056/NEJMoa1314768.
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Probiotics and prebiotics in dermatology.益生菌和益生元在皮肤科的应用。
J Am Acad Dermatol. 2014 Oct;71(4):814-21. doi: 10.1016/j.jaad.2014.04.050. Epub 2014 Jun 4.
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Toll-like receptor 2 ligands promote chronic atopic dermatitis through IL-4-mediated suppression of IL-10.Toll 样受体 2 配体通过 IL-4 介导的 IL-10 抑制促进慢性特应性皮炎。
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Immunology of atopic dermatitis: novel insights into mechanisms and immunomodulatory therapies.特应性皮炎的免疫学:对发病机制和免疫调节疗法的新见解。
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The epithelial cell-derived atopic dermatitis cytokine TSLP activates neurons to induce itch.上皮细胞衍生的特应性皮炎细胞因子 TSLP 激活神经元以诱导瘙痒。
Cell. 2013 Oct 10;155(2):285-95. doi: 10.1016/j.cell.2013.08.057. Epub 2013 Oct 3.
9
Nonpathogenic bacteria alleviating atopic dermatitis inflammation induce IL-10-producing dendritic cells and regulatory Tr1 cells.非致病性细菌缓解特应性皮炎炎症诱导产生白细胞介素-10 产生树突状细胞和调节性 Tr1 细胞。
J Invest Dermatol. 2014 Jan;134(1):96-104. doi: 10.1038/jid.2013.291. Epub 2013 Jun 28.
10
[Paradoxical skin reactions under therapy with TNF-alpha antagonists].[肿瘤坏死因子-α拮抗剂治疗期间出现的矛盾性皮肤反应]
Z Rheumatol. 2013 Jun;72(5):423-8. doi: 10.1007/s00393-012-1127-0.