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生物制剂在特应性皮炎中的疗效。

Efficacy of biologics in atopic dermatitis.

机构信息

Department of Dermatology, Laboratory of Inflammatory Skin Diseases, Icahn School of Medicine at Mount Sinai, New York, USA.

College of Medicine, State University of New York Downstate Medical Center, Brooklyn, NY, USA.

出版信息

Expert Opin Biol Ther. 2020 May;20(5):525-538. doi: 10.1080/14712598.2020.1722998. Epub 2020 Feb 3.

Abstract

: Atopic dermatitis (AD) is a heterogeneous disease. Recent advancements in understanding AD pathogenesis resulted in the exponential expansion of its therapeutic pipeline, particularly following the success and FDA-approval of dupilumab. Different phenotypes of AD by age and ethnicity have also recently been described and clinical studies of emerging treatments will further clarify the role of each cytokine pathway in AD.: We review the impressive repertoire of biologics for treatment of moderate-to-severe AD, including those targeting Th2, Th22, Th17/IL-23 and IgE. We highlight the scientific rationale behind each approach and provide a discussion of the most recent clinical efficacy and safety data.: AD is a complex disease and recent research has identified numerous endotypes, reinforcing the rationale for developing targeted therapeutics to antagonize these factors. Dupilumab has revolutionized AD treatment and its mechanistic studies also offer crucial insight into AD pathogenesis. Nevertheless, this biologic does not work for everyone, highlighting the need for a more precise approach to address the unique immune fingerprints of each AD subset. Ultimately targeted therapeutics will complement our understanding of the AD molecular map and help push AD management into an era of personalized medicine.

摘要

特应性皮炎(AD)是一种异质性疾病。对 AD 发病机制的理解的最新进展导致其治疗领域迅速扩大,尤其是在度普利尤单抗成功并获得 FDA 批准之后。最近还描述了按年龄和种族划分的不同 AD 表型,而新兴治疗方法的临床研究将进一步阐明 AD 中每种细胞因子途径的作用。

我们回顾了治疗中重度 AD 的大量生物制剂,包括针对 Th2、Th22、Th17/IL-23 和 IgE 的生物制剂。我们强调了每种方法背后的科学原理,并讨论了最近的临床疗效和安全性数据。

AD 是一种复杂的疾病,最近的研究确定了许多表型,这进一步证明了开发针对这些因素的靶向治疗的合理性。度普利尤单抗彻底改变了 AD 的治疗方法,其机制研究也为 AD 的发病机制提供了重要的见解。然而,这种生物制剂并非对所有人都有效,这突出表明需要更精确的方法来解决每个 AD 亚群独特的免疫特征。最终,靶向治疗将补充我们对 AD 分子图谱的理解,并有助于将 AD 管理推向个性化医疗时代。

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