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瘙痒症的治疗:过敏性湿疹的当前临床标准与疗法

Cure for the itch: current clinical standards and therapies in allergic eczema.

作者信息

Lazor Jennifer E, Bozsoki Bree A, Bharadwaj Pranay

机构信息

Biotherapeutics Discovery, Boehringer Ingelheim Pharmaceuticals Inc., Ridgefield, CT, United States.

出版信息

Front Allergy. 2025 Apr 3;6:1569292. doi: 10.3389/falgy.2025.1569292. eCollection 2025.

DOI:10.3389/falgy.2025.1569292
PMID:40248667
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12003377/
Abstract

Allergic Eczema (AE) is a chronic, relapsing skin condition that significantly affects the quality of life of the AE patients and their caretakers. Decades of scientific and clinical research has helped understand the highly complex underpinnings of AE presentation wherein a multitude of variables, including the conspicuous variables such as environmental allergens, immunological triggers, genetic predisposition of individuals, to more nuanced socio-economic status, play an important part. Given the complexity of the disease, it is imperative to develop biomarkers enabling early and reliable clinical identifications and help in the active management of the disease, thereby minimizing the impact and burden of the disease on the patients. In this mini review, we provide a brief overview of AE, affected demographics, variables that trigger its onset, and summarize the discovery of various clinical biomarkers such as total and specific serum IgE levels, Th2 cytokine levels, filaggrin (FLG) mutations, periostin levels in skin, etc. that have been developed over the years to further improve the state of clinical monitoring of AE presentation and progression. Lastly, we also provide an overview of the clinical interventions and therapies, such as topical agents, phototherapy, and biologics, that are available to the patients to manage AE-related complications. While we have vastly improved the standard of care and diagnosis for the AE patients, there are still many unmet needs such as developing non-invasive, effective, and reliable clinical predictors and biomarkers which can usher better personalized treatments and provide a better quality of life to affected demographics.

摘要

过敏性湿疹(AE)是一种慢性复发性皮肤病,严重影响AE患者及其护理人员的生活质量。数十年的科学和临床研究有助于理解AE表现的高度复杂的基础,其中众多变量,包括环境过敏原、免疫触发因素、个体遗传易感性等明显变量,以及更细微的社会经济地位,都起着重要作用。鉴于该疾病的复杂性,开发能够实现早期和可靠临床识别的生物标志物并有助于疾病的积极管理,从而将疾病对患者的影响和负担降至最低,这一点至关重要。在本综述中,我们简要概述了AE、受影响的人群、引发其发病的变量,并总结了多年来开发的各种临床生物标志物的发现,如总血清IgE和特异性血清IgE水平、Th2细胞因子水平、丝聚蛋白(FLG)突变、皮肤中骨膜蛋白水平等,以进一步改善对AE表现和进展的临床监测状况。最后,我们还概述了可供患者用于管理AE相关并发症的临床干预措施和治疗方法,如局部用药、光疗和生物制剂。虽然我们已经极大地提高了AE患者的护理和诊断标准,但仍有许多未满足的需求,例如开发无创、有效且可靠的临床预测指标和生物标志物,这可以带来更好的个性化治疗,并为受影响人群提供更高的生活质量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/11b2/12003377/a18602528629/falgy-06-1569292-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/11b2/12003377/a18602528629/falgy-06-1569292-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/11b2/12003377/a18602528629/falgy-06-1569292-g001.jpg

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本文引用的文献

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Th Pathways in Immune-Mediated Skin Disorders: A Guide for Strategic Treatment Decisions.免疫介导性皮肤病的治疗途径:战略治疗决策指南
Immune Netw. 2024 Aug 14;24(5):e33. doi: 10.4110/in.2024.24.e33. eCollection 2024 Oct.
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What is "eczema"?什么是“湿疹”?
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Roflumilast Cream, 0.15%, for Atopic Dermatitis in Adults and Children: INTEGUMENT-1 and INTEGUMENT-2 Randomized Clinical Trials.0.15%罗氟司特乳膏用于成人和儿童特应性皮炎:INTEGUMENT-1和INTEGUMENT-2随机临床试验
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Clinical Evaluation of the Safety and Tolerability of Film-Forming Sprays in Patients With Psoriasis and Eczema.银屑病和湿疹患者中成膜喷雾剂安全性和耐受性的临床评估
Cureus. 2024 Mar 27;16(3):e57020. doi: 10.7759/cureus.57020. eCollection 2024 Mar.
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Evaluation of Antioxidant Activity and Treatment of Eczema by Berberine Hydrochloride-Loaded Liposomes-in-Gel.盐酸小檗碱脂质体凝胶的抗氧化活性评价及湿疹治疗作用
Molecules. 2024 Mar 31;29(7):1566. doi: 10.3390/molecules29071566.
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Exploring the Potential of IL-4 and IL-13 Plasma Levels as Biomarkers in Atopic Dermatitis.探索白细胞介素-4和白细胞介素-13血浆水平作为特应性皮炎生物标志物的潜力。
Life (Basel). 2024 Mar 7;14(3):352. doi: 10.3390/life14030352.
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Atopic dermatitis (eczema) guidelines: 2023 American Academy of Allergy, Asthma and Immunology/American College of Allergy, Asthma and Immunology Joint Task Force on Practice Parameters GRADE- and Institute of Medicine-based recommendations.特应性皮炎(湿疹)指南:2023 年美国过敏、哮喘和免疫学学会/美国过敏、哮喘和免疫学学会联合工作组关于实践参数的推荐意见,基于 GRADE 分级和医学研究所的建议。
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