Division of Immunodermatology and Allergy Research, Department for Dermatology, Allergy and Venereology, Hannover Medical School, Hannover, Lower Saxony, Germany.
Curr Opin Allergy Clin Immunol. 2020 Aug;20(4):386-394. doi: 10.1097/ACI.0000000000000652.
This review reports on published clinical studies (full publications) with novel therapeutic agents on the treatment of atopic dermatitis with a focus on the last 2 years.
Atopic dermatitis is a T-cell driven complex inflammatory skin disease. The secretion of cytokines involving not only particularly Th2 but also Th17 and Th22 cell subsets provides a broad spectrum of potential therapeutical targets. A couple of studies on atopic dermatitis with new therapeutical antibodies that target not only the Th2 cytokines IL-4, IL-13, IL- 31 but also additional targets, such as TSLP, IL-22 or IL-33, and innovative small molecules binding to the histamine-4 receptor, the phosphodiesterase-4, the aryl hydrocarbon receptor or downstream molecules like Janus kinases have recently been published with promising results on symptoms and signs of atopic dermatitis.
Applications of newly developed drugs in clinical studies or already in daily practice show a substantial progress in the treatment of moderately to severely affected patients with atopic dermatitis not responsive to standard topical treatments with corticosteroids or topical calcineurin inhibitors alone. Moreover, novel treatment approaches generate new knowledge about (anti)inflammatory effects of immune modulations in atopic dermatitis and the heterogeneity of patient subgroups, which may stimulate further innovations in this field.
本综述报告了过去 2 年中,新型治疗药物治疗特应性皮炎的临床研究(全文)。
特应性皮炎是一种由 T 细胞驱动的复杂炎症性皮肤病。涉及的细胞因子分泌不仅涉及 Th2 细胞,还涉及 Th17 和 Th22 细胞亚群,为广泛的潜在治疗靶点提供了可能。一些关于特应性皮炎的新治疗性抗体的研究,这些抗体不仅针对 Th2 细胞因子 IL-4、IL-13、IL-31,还针对其他靶点,如 TSLP、IL-22 或 IL-33,以及创新的小分子,这些药物与组胺-4 受体、磷酸二酯酶-4、芳香烃受体或下游分子(如 Janus 激酶)结合,在特应性皮炎的症状和体征方面取得了有希望的结果。
新开发药物在临床研究中的应用或已在日常实践中应用,显示出在治疗对标准局部皮质类固醇或单独局部钙调神经磷酸酶抑制剂治疗反应不佳的中重度特应性皮炎患者方面取得了实质性进展。此外,新的治疗方法为特应性皮炎的免疫调节(抗炎)作用和患者亚组的异质性提供了新的认识,这可能会刺激该领域的进一步创新。