Dermatologic Unit, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.
Dermatologic Unit, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.
J Pharmacol Sci. 2020 Sep;144(1):52-56. doi: 10.1016/j.jphs.2020.06.003. Epub 2020 Jun 11.
The use of biological drugs in psoriasis is replacing traditional therapies due to their specific mechanism and limited side effects. However, the use of Interleukin 17 inhibitors and the modification of its cytokine pathway could favor the risk of fungal infections. All-trans retinoic acid is an active metabolite of vitamin A with anti-inflammatory and immunoregulatory properties through its capacity to stimulate both innate and adaptive immunity and to its effects on proliferation, differentiation and apoptosis in a variety of immune cells. Furthermore, it has been recently discovered that All-trans retinoic acid has a direct fungistatic effect against Candida and Aspergillus Fumigatus. On the basis of these new insights, in the current review, we suggest that the evaluation of serum level of All-trans retinoic acid or vitamin A should be considered as a predictive marker for the development of fungal infections among psoriatic patients treated with Interleukin 17 inhibitors. In clinical practice, vitamin A test could be added in the routine hospital diagnostic management for a better selection of psoriatic patients eligible to Interleukin 17 inhibitors.
生物药物在银屑病中的应用正在取代传统疗法，因为它们具有特定的作用机制和有限的副作用。然而，白细胞介素 17 抑制剂的使用及其细胞因子途径的修饰可能会增加真菌感染的风险。全反式维甲酸是维生素 A 的一种活性代谢物，具有抗炎和免疫调节特性，通过刺激固有免疫和适应性免疫及其对多种免疫细胞增殖、分化和凋亡的影响来实现。此外，最近发现全反式维甲酸对念珠菌和烟曲霉具有直接的抑菌作用。基于这些新的认识，在目前的综述中，我们建议评估血清全反式维甲酸或维生素 A 水平应被视为预测接受白细胞介素 17 抑制剂治疗的银屑病患者发生真菌感染的标志物。在临床实践中，维生素 A 检测可作为常规医院诊断管理的附加项目，以更好地选择适合接受白细胞介素 17 抑制剂治疗的银屑病患者。
