Department of Infection, Immunity and Cardiovascular Disease, Sheffield Dermatology Research, The University of Sheffield Medical School, Sheffield, United Kingdom.
Dermatology Consulting Services, NC, USA.
J Dermatolog Treat. 2022 Mar;33(2):685-698. doi: 10.1080/09546634.2020.1789050. Epub 2020 Jul 16.
A topical vehicle is a 'carrier system' for an active pharmaceutical (or cosmetic) substance, referred to hereafter as the drug, but a vehicle may also be used on its own as an emollient to ameliorate dry skin. It is well established that the vehicle plays an important role in determining the bioavailability of a given drug at its ultimate target within the skin. Yet in the treatment of atopic eczema/dermatitis (AD), wherein the structure and function of the skin's outer barrier play a pivotal role in the development and course of the condition, the interaction of the vehicle with this barrier carries a particular importance. It is now clear that the often-considered inert excipients of a vehicle bring about changes within the skin at the molecular level that promote barrier restoration and enhance innate immune defenses with therapeutic value to AD patients. Moreover, the vehicle control in randomized controlled trials (RCTs) increasingly displays significant efficacy. In light of this, we consider the implications of vehicle design in relation to AD pathophysiology and the role vehicles play as controls in RCTs of new drug treatments for this condition.
一种局部用制剂是一种药物（或化妆品）活性物质的“载体系统”，以下简称药物，但载体本身也可单独用作保湿剂来改善皮肤干燥。众所周知，载体在确定药物在皮肤内最终靶标处的生物利用度方面起着重要作用。然而，在特应性皮炎/湿疹（AD）的治疗中，皮肤外层屏障的结构和功能在疾病的发展和进程中起着关键作用，载体与该屏障的相互作用具有特殊的重要性。现在已经清楚的是，载体中通常被认为是惰性的赋形剂在分子水平上引起皮肤内的变化，促进屏障的恢复，并增强对 AD 患者具有治疗价值的固有免疫防御。此外，在随机对照试验（RCT）中，载体的控制显示出显著的疗效。有鉴于此，我们考虑了载体设计与 AD 病理生理学的关系，以及载体在该疾病新药物治疗 RCT 中作为对照的作用。
