Department of Dermatology, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Department of Dermatology, Kyoto University Graduate School of Medicine, Kyoto, Japan.
J Allergy Clin Immunol. 2017 Aug;140(2):369-376. doi: 10.1016/j.jaci.2017.06.005. Epub 2017 Jun 23.
This review highlights recent key advances in the pathology and therapies of inflammatory skin diseases, focusing on atopic dermatitis (AD) and chronic spontaneous urticaria (CSU). Regarding AD, transcriptomic analysis with human samples revealed different immune profiles between childhood and adult AD. Phase III clinical trials of dupilumab, an anti-IL-4 receptor α antibody, in the treatment of AD have successfully finished, and dupilumab will appear in clinical practice as the first biologic for AD in 2017. In addition, a novel biologic that targets IL-31 shows promising results in a phase II trial. As for the skin microbiome study, novel insights into the mechanisms of microbial dysbiosis, such as colonization of Staphylococcus aureus, a common feature of AD, were proposed. Regarding CSU, autoreactive CD4 T cells that react to FcεRI were discovered, which might contribute to the development of CSU. These findings provide new insights into the pathogenesis of AD and CSU and will lead to more specific and personalized treatments.
这篇综述重点介绍了炎症性皮肤病病理学和治疗学的最新重要进展,重点关注特应性皮炎(AD)和慢性自发性荨麻疹(CSU)。关于 AD,利用人类样本进行的转录组分析揭示了儿童期 AD 和成年 AD 之间不同的免疫特征。抗 IL-4 受体 α 抗体 dupilumab 治疗 AD 的 III 期临床试验已经成功完成,dupilumab 将作为 AD 的首个生物制剂于 2017 年在临床上出现。此外,一种靶向 IL-31 的新型生物制剂在 II 期试验中显示出良好的效果。至于皮肤微生物组的研究,提出了微生物失调机制的新见解,如金黄色葡萄球菌定植,这是 AD 的一个常见特征。关于 CSU,发现了对 FcεRI 反应的自身反应性 CD4 T 细胞,这可能有助于 CSU 的发展。这些发现为 AD 和 CSU 的发病机制提供了新的见解,并将导致更具体和个性化的治疗。