RESUMEN
Dupilumab, the first biologic approved for treatment of atopic dermatitis, has demonstrated significant clinical effect and quality of life-enhancing capacity in clinical trials. In these, dupilumab-associated conjunctivitis where reported in a minority of patients. The present case series describe 10 patients treated with dupilumab where eye complications were very common. We have described patient characteristics, including FLG mutations, atopic history and clinical effect of dupilumab. Nine of 10 developed eye-complications, most commonly conjunctivitis (in 7/10). Other adverse events were herpes simplex virus uveitis and varicella-zoster virus meningitis. Although our case series is small, we conclude that dupilumab is an effective treatment option in severe atopic dermatitis, but that the risk of adverse events from the eyes and recurrence of herpes virus infections should be kept in mind. Close collaboration with an ophthalmologist is recommended, especially among patients with severe, long-lasting atopic dermatitis and/or previous eye disease.
Asunto(s)
Anticuerpos Monoclonales/efectos adversos , Productos Biológicos/efectos adversos , Conjuntivitis/inducido químicamente , Dermatitis Atópica/tratamiento farmacológico , Adulto , Anticuerpos Monoclonales Humanizados , Conjuntivitis/diagnóstico , Conjuntivitis/inmunología , Dermatitis Atópica/diagnóstico , Dermatitis Atópica/inmunología , Infecciones Virales del Ojo/inducido químicamente , Infecciones Virales del Ojo/inmunología , Femenino , Proteínas Filagrina , Herpes Simple/inducido químicamente , Herpes Simple/inmunología , Herpes Simple/virología , Herpes Zóster/inducido químicamente , Herpes Zóster/inmunología , Herpes Zóster/virología , Humanos , Huésped Inmunocomprometido , Masculino , Meningitis Viral/inducido químicamente , Meningitis Viral/inmunología , Meningitis Viral/virología , Persona de Mediana Edad , Infecciones Oportunistas/inducido químicamente , Infecciones Oportunistas/inmunología , Infecciones Oportunistas/virología , Medición de Riesgo , Factores de Riesgo , Índice de Severidad de la Enfermedad , Resultado del Tratamiento , Uveítis Anterior/inducido químicamente , Uveítis Anterior/inmunología , Uveítis Anterior/virología , Adulto JovenRESUMEN
PURPOSE: To examine the effects of n-3 and n-6 polyunsaturated fatty acids (n-3 and n-6 PUFAs) in a murine model of herpetic chorioretinitis. METHODS: BALB/c mice were fed on three high fat diets, which contained: Menhaden oil (rich in n-3 PUFAs); Safflower oil (rich in n-6 PUFAs); or Corn oil (rich in saturated fatty acids) as control group, 14 days previously and until 12 days following anterior chamber (AC) HSV-1 inoculation. RESULTS: Mice fed on Menhaden oil present an early development of contralateral chorioretinitis by day 6 post-AC HSV-1 inoculation and also significant increase of RNA HSV-1 expression compared with Safflower and Corn oil groups. Furthermore, mice fed on Menhaden oil showed a significant decrease secretion of TNF-α, IFN-γ, IL-2 and IL-10 in splenic cells and both retinas. CONCLUSION: Our results showed that mice fed on Menhaden oil (n-3 PUFAs) presented an early development of contralateral chorioretinitis by day 6 post-AC HSV-1 inoculation and also a significant increase in RNA HSV-1 expression compared with animals fed on Safflower and Corn oils. This increase of HSV-1 could be associated with the higher development of chorioretinitis.