Kura Mahendra M, Sodhi Anmol, Sajgane Avinash, Karande Ashish
Department of Dermatology, Venereology and Leprosy, Grant Government Medical College, Sir JJ Group of Hospitals, Mumbai, Maharashtra, India.
Indian J Dermatol. 2022 Sep-Oct;67(5):568-572. doi: 10.4103/ijd.ijd_180_21.
Generalised pustular psoriasis (GPP) is an uncommon, severe, life-threatening variant of psoriasis requiring careful therapeutic approach. Conventional treatment modalities have unsatisfactory outcomes, poor side effect profiles and toxicities that have led to an emerging use of biological therapies. Itolizumab, an anti-CD-6 humanised monoclonal IgG1 antibody, is approved for the management of chronic plaque psoriasis in India. We share our experience of using this drug in three cases of GPP that were failing conventional therapies. Its upstream effect on co-stimulatory pathway in disease pathogenesis is the postulated mechanism. Our experience warrants further large-scale exploration of the role of itolizumab in the management of GPP, which would benefit this severely affected population of patients. Although the definite pathogenesis of GPP is unknown fully, molecules blocking CD-6, which plays a role in the interaction between T cells and antigen-presenting cells (APCs), are expected as new promising treatment options for GPP.
泛发性脓疱型银屑病（GPP）是一种罕见、严重且危及生命的银屑病变体，需要谨慎的治疗方法。传统治疗方式效果不佳，副作用大且毒性强，这导致生物疗法的使用日益增加。依托珠单抗是一种抗CD-6人源化单克隆IgG1抗体，在印度被批准用于治疗慢性斑块状银屑病。我们分享了在3例常规治疗失败的GPP患者中使用该药物的经验。其在疾病发病机制中对共刺激途径的上游作用是推测的机制。我们的经验值得进一步大规模探索依托珠单抗在GPP治疗中的作用，这将使这一严重受影响的患者群体受益。尽管GPP的确切发病机制尚不完全清楚，但阻断在T细胞与抗原呈递细胞（APC）相互作用中起作用的CD-6的分子有望成为GPP新的有前景的治疗选择。
