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1.
Wiad Lek ; 74(2): 310-312, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33813492

RESUMO

OBJECTIVE: The aim: Was to evaluate clinical data after the use of pimecrolimus (1% cream "Elidel") in patients with mild and moderate severity of atopic cheilitis, according to modern therapeutic requirements. There was an algorithm of treatment the patients with cheilitis proposed it based on the data from literary sources and personal clinical experience. PATIENTS AND METHODS: Materials and methods: 22 patients with atopic cheilitis aged from 19 to 40 agreed on a clinical examination in accordance with the protocol of the study. Patients were prescribed "Elidel" in the form of 1% cream for lubrication of the affected areas of the skin and lips, and antihistamine "Erius", for the normalization of the general condition used sedatives and vitamins after consultation of specialists in the general profile. RESULTS: Results: Patients of both groups during the re-examination after 3, 7, 10 days recorded a positive dynamics of the red border of the lips and skin: a significant reduction in the inflammatory process, normalization of indicators of general blood analysis, improvement in the overall quality of life of patients. CONCLUSION: Conclusions: The results of treatment allow to consider 1% cream "Elidel" (pimecrolimus) as a preparation of choice in the complex treatment of patients with atopic cheilitis of mild and moderate severity.


Assuntos
Queilite , Dermatite Atópica , Idoso , Queilite/tratamento farmacológico , Dermatite Atópica/tratamento farmacológico , Humanos , Qualidade de Vida , Índice de Gravidade de Doença , Pele , Resultado do Tratamento
3.
Molecules ; 26(4)2021 Feb 22.
Artigo em Inglês | MEDLINE | ID: mdl-33671791

RESUMO

Peptide materials have recently been considered for use in various industrial fields. Because of their efficacy, safety, and low cost, therapeutic peptides are studied for various diseases, including atopic dermatitis (AD). AD is a common inflammatory skin disease impairing the patient's quality of life. Various therapies, such as treatments with corticosteroids, calcineurin inhibitors, and antibody drugs, have been applied, but numerous side effects have been reported, including skin atrophy, burning, and infection. In the case of antibody drugs, immunogenicity against the drugs can be a problem. To overcome these side effects, small peptides are considered therapeutic agents. We previously identified the small wound healing peptide AES16-2M with a sequence of REGRT, and examined its effects on AD in this study. Interestingly, the administration of AES16-2M downregulated the AD disease score, ear thickness, serum IgE, and thymic stromal lymphopoietin (TSLP) in AD mice. The thickness of the epidermal layer was also improved by AES16-2M treatment. In addition, quantities of IL-4-, IL-13-, and IL-17-producing CD4 T cells from peripheral lymph nodes and spleens were reduced by injection of AES16-2M. Furthermore, the expression of TSLP was significantly reduced in AES16-2M-treated human keratinocytes. Therefore, these results suggest that AES16-2M can be a novel candidate for AD treatment.


Assuntos
Dermatite Atópica/tratamento farmacológico , Peptídeos/farmacologia , Cicatrização/efeitos dos fármacos , Animais , Linhagem Celular , Dermatophagoides farinae , Modelos Animais de Doenças , Feminino , Humanos , Camundongos , Peptídeos/síntese química , Peptídeos/química
4.
N Engl J Med ; 384(12): 1101-1112, 2021 03 25.
Artigo em Inglês | MEDLINE | ID: mdl-33761207

RESUMO

BACKGROUND: The oral Janus kinase 1 (JAK1) inhibitor abrocitinib, which reduces interleukin-4 and interleukin-13 signaling, is being investigated for the treatment of atopic dermatitis. Data from trials comparing JAK1 inhibitors with monoclonal antibodies, such as dupilumab, that block interleukin-4 receptors are limited. METHODS: In a phase 3, double-blind trial, we randomly assigned patients with atopic dermatitis that was unresponsive to topical agents or that warranted systemic therapy (in a 2:2:2:1 ratio) to receive 200 mg or 100 mg of abrocitinib orally once daily, 300 mg of dupilumab subcutaneously every other week (after a loading dose of 600 mg), or placebo; all the patients received topical therapy. The primary end points were an Investigator's Global Assessment (IGA) response (defined as a score of 0 [clear] or 1 [almost clear] on the IGA [scores range from 0 to 4], with an improvement of ≥2 points from baseline) and an Eczema Area and Severity Index-75 (EASI-75) response (defined as ≥75% improvement from baseline in the score on the EASI [scores range from 0 to 72]) at week 12. The key secondary end points were itch response (defined as an improvement of ≥4 points in the score on the Peak Pruritus Numerical Rating Scale [scores range from 0 to 10]) at week 2 and IGA and EASI-75 responses at week 16. RESULTS: A total of 838 patients underwent randomization; 226 patients were assigned to the 200-mg abrocitinib group, 238 to the 100-mg abrocitinib group, 243 to the dupilumab group, and 131 to the placebo group. An IGA response at week 12 was observed in 48.4% of patients in the 200-mg abrocitinib group, 36.6% in the 100-mg abrocitinib group, 36.5% in the dupilumab group, and 14.0% in the placebo group (P<0.001 for both abrocitinib doses vs. placebo); an EASI-75 response at week 12 was observed in 70.3%, 58.7%, 58.1%, and 27.1%, respectively (P<0.001 for both abrocitinib doses vs. placebo). The 200-mg dose, but not the 100-mg dose, of abrocitinib was superior to dupilumab with respect to itch response at week 2. Neither abrocitinib dose differed significantly from dupilumab with respect to most other key secondary end-point comparisons at week 16. Nausea occurred in 11.1% of the patients in the 200-mg abrocitinib group and 4.2% of those in the 100-mg abrocitinib group, and acne occurred in 6.6% and 2.9%, respectively. CONCLUSIONS: In this trial, abrocitinib at a dose of either 200 mg or 100 mg once daily resulted in significantly greater reductions in signs and symptoms of moderate-to-severe atopic dermatitis than placebo at weeks 12 and 16. The 200-mg dose, but not the 100-mg dose, of abrocitinib was superior to dupilumab with respect to itch response at week 2. Neither abrocitinib dose differed significantly from dupilumab with respect to most other key secondary end-point comparisons at week 16. (Funded by Pfizer; JADE COMPARE ClinicalTrials.gov number, NCT03720470.).


Assuntos
Anticorpos Monoclonais Humanizados/uso terapêutico , Dermatite Atópica/tratamento farmacológico , Inibidores de Proteínas Quinases/administração & dosagem , Pirimidinas/administração & dosagem , Sulfonamidas/administração & dosagem , Administração Oral , Adulto , Anticorpos Monoclonais Humanizados/efeitos adversos , Relação Dose-Resposta a Droga , Método Duplo-Cego , Feminino , Humanos , Imunoglobulina A/sangue , Injeções Subcutâneas , Subunidade alfa de Receptor de Interleucina-4/antagonistas & inibidores , Janus Quinase 1/antagonistas & inibidores , Masculino , Placebos/uso terapêutico , Inibidores de Proteínas Quinases/efeitos adversos , Prurido/tratamento farmacológico , Pirimidinas/efeitos adversos , Índice de Gravidade de Doença , Sulfonamidas/efeitos adversos
5.
Zhongguo Zhong Yao Za Zhi ; 46(4): 762-766, 2021 Feb.
Artigo em Chinês | MEDLINE | ID: mdl-33645108

RESUMO

Based on the clinical characteristics of atopic dermatitis( AD) in traditional Chinese medicine( TCM) and Western medicine,the existing animal models were analyzed,and the coincidence degree,advantages and disadvantages between the models and the clinical manifestations of AD were evaluated,so as to provide reference for establishing a rational animal model. After consulting relevant literatures in recent years and summarizing the existing modeling methods,it is found that spontaneous,transgenic/gene knockout models were highly consistent,but with high breeding conditions and expensive prices. The hapten-induced model was low in cost and fast in modeling. It revealed the corresponding mechanism of AD to a certain extent,but did not fully reflect the state of the entire process of AD. The modeling method was guided by Western medicine,but with a lack of pathogenic factors of traditional Chinese medicine,and so has certain limitations in TCM research. Therefore,it is necessary to combine the etiology,pathogenesis and clinical mani-festations of AD with traditional Chinese and Western medicine,so as to improve the coincidence degree between the model and the characteristics of clinical symptoms and lay the foundation for in-depth studies on AD.


Assuntos
Dermatite Atópica , Medicamentos de Ervas Chinesas , Eczema , Medicina , Animais , China , Dermatite Atópica/tratamento farmacológico , Dermatite Atópica/genética , Medicina Tradicional Chinesa
7.
AAPS PharmSciTech ; 22(2): 55, 2021 Jan 24.
Artigo em Inglês | MEDLINE | ID: mdl-33486609

RESUMO

Globally, the prevalence of Atopic dermatitis (AD) is significantly increasing and affecting around 20% of population including children. Complex interactions amongst abnormality in epidermal barrier function, environment, infectious agents and immunological defects are considered as key factors in the pathogenesis of AD. Although the role of oxidative stress has been studied in some skin diseases, investigation of the same in AD is intermittent. Calcineurin inhibitors and/or topical corticosteroids are currently available; however, it causes atrophy of the skin, burning sensation, and systemic side effects which leads to poor patient compliance. These limitations provoke the strong need to develop an innovative approach in managing AD. Nanomaterials for effective drug delivery to skin conditions such as AD have attracted a lot of attention owing to its ability to encapsulate, protect, and release the cargo at the diseased skin site. However, there are lots of unmet challenges especially in terms of development of non-toxic formulations and clinical translation of established nanomedicines in the form of accessible products. Numerous formulations have emerged as carrier for poorly soluble and permeable drugs, viz., lipidic, polymeric, metal, silica, liposomes, hydrocarbon gels and this field is evolving. This review is intended to provide an insight incidences associated with pathophysiology of AD and challenges with existing treatments of AD. Focus is kept on reviewing current development and emerging nanomedicines for effective treatment of AD. The review also inculcates merits of several nanomedicines in overcoming challenges of existing products and its future implications.


Assuntos
Dermatite Atópica/tratamento farmacológico , Nanomedicina , Animais , Ensaios Clínicos como Assunto , Dermatite Atópica/epidemiologia , Dermatite Atópica/etiologia , Composição de Medicamentos , Emulsões , Humanos , Micelas , Nanopartículas
10.
J Dermatolog Treat ; 32(2): 164-173, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33461356

RESUMO

BACKGROUND: Insights into the real-world treatment paradigm and long-term burden of atopic dermatitis (AD) are needed to inform clinical and health policy decisions. METHODS: The prospective, observational EUROSTAD study enrolled adults with moderate-to-severe AD starting or switching systemic therapy (51 sites in 10 European countries). We report the baseline characteristics, treatment patterns, and outcomes of these patients using descriptive statistics. RESULTS: A 12-month enrollment period of EUROSTAD was completed and 308 patients were enrolled: average age 37 years, AD duration 25 years, 43% were female. Most patients reported use of systemic therapy (93%) and ≥1 atopic comorbidity (82%). Mean [standard deviation] disease severity/burden measures were high: Investigator's Global Assessment (3.1 [0.8]), Eczema Area and Severity Index (16.2 [10.9]), Peak Pruritus Numerical Rating Scale (5.5 [2.5]), sleep impairment Visual Analog Scale (49.8 [31.6]) scores, and time lost from work (4.1 [13.7] days/year) or usual activities (16.8 [38.7] days/year). Most patients showed borderline or clinical levels of anxiety (59%) and/or depression (63%) using the Hospital Anxiety and Depression Scale. CONCLUSIONS: Adults with moderate-to-severe AD starting/switching systemic treatment enrolled in EUROSTAD have a high burden of longstanding disease despite continuous use of topical drugs, emollients, and systemic therapies.


Assuntos
Efeitos Psicossociais da Doença , Dermatite Atópica/tratamento farmacológico , Fármacos Dermatológicos/uso terapêutico , Adolescente , Corticosteroides/uso terapêutico , Adulto , Idoso , Idoso de 80 Anos ou mais , Comorbidade , Ciclosporina/uso terapêutico , Dermatite Atópica/epidemiologia , Dermatite Atópica/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Prospectivos , Qualidade de Vida , Índice de Gravidade de Doença , Adulto Jovem
11.
J Dermatolog Treat ; 32(1): 19-28, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31693426

RESUMO

Importance: While dupilumab has emerged as an effective treatment for moderate-to-severe atopic dermatitis (AD) since its approval in 2017, interleukin-4 and 13 blockade has also demonstrated efficacy in off-label chronic dermatologic conditions.Objective: To identify chronic dermatologic conditions in which dupilumab has demonstrated efficacy.Findings: Thirty-three reports of dupilumab use in non-AD dermatologic conditions were identified through systematic literature review. Effective use of dupilumab has been reported in case reports and case series in the treatment of chronic pruritus, prurigo nodularis, eczematous eruption of aging, allergic contact dermatitis, chronic hand eczema, alopecia areata, urticaria, eosinophilic annular erythema, bullous pemphigoid and papuloerythroderma of Ofuji. Clinical trials are underway evaluating the efficacy of dupilumab in allergic contact dermatitis, chronic hand eczema, alopecia areata, chronic spontaneous urticaria and cholinergic urticaria.Conclusions and relevance: Overlap in immune signaling pathways between AD and chronic pruritus, eczematous eruption of aging, allergic contact dermatitis, chronic hand eczema, alopecia areata, urticaria, eosinophilic annular erythema, bullous pemphigoid and papuloerythroderma of Ofuji make these conditions candidates for dupilumab therapy when standard treatments have failed or are contraindicated. While promising as a therapeutic option, off-label prescribing of dupilumab requires consideration of challenges in insurance authorization and out-of-pocket cost to the patient.


Assuntos
Anticorpos Monoclonais Humanizados/uso terapêutico , Dermatite Atópica/tratamento farmacológico , Alopecia em Áreas/tratamento farmacológico , Anticorpos Monoclonais/uso terapêutico , Eczema/tratamento farmacológico , Humanos , Urticária/tratamento farmacológico
12.
J Dermatolog Treat ; 32(1): 114-116, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31132923

RESUMO

Background: Dupilumab is used for treatment of atopic dermatitis through blockade of IL-4 and IL-13 signaling of the Th2 pathway. Recent case reports have described alopecia, psoriasis, persistent facial dermatitis, and recall dermatitis at patch test sites after the initiation of dupilumab therapy.Case report: We describe the case of a 67-year-old female with atopic dermatitis who developed recurrent episodic flares of rosacea temporally associated with dupilumab injections that resolved after dupilumab discontinuation.Conclusion: The cause of rosacea-like reaction associated with dupilumab treatment is unknown. Th2 pathway inhibition by dupilumab may promote Demodex proliferation and increased IL-17-mediated inflammation implicated in the pathophysiology of rosacea.Abbreviations: atopic dermatitis: AD; interleukin: IL; persistent facial dermatitis: PFD; T-helper cell type 1: Th1; T-helper cell type 2: Th2; T-helper cell type 17: Th17; tumor necrosis factor-∝: TNF-∝.


Assuntos
Anticorpos Monoclonais Humanizados/uso terapêutico , Dermatite Atópica/tratamento farmacológico , Rosácea/diagnóstico , Idoso , Anticorpos Monoclonais Humanizados/efeitos adversos , Eritema/etiologia , Feminino , Humanos , Subunidade alfa de Receptor de Interleucina-4/antagonistas & inibidores , Subunidade alfa de Receptor de Interleucina-4/metabolismo , Recidiva , Rosácea/etiologia
13.
Ann Allergy Asthma Immunol ; 126(1): 40-45, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-32739313

RESUMO

BACKGROUND: The real-world persistence with dupilumab therapy for atopic dermatitis (AD) is unknown. OBJECTIVE: To characterize adults with AD who initiated dupilumab and evaluate persistence with dupilumab therapy. METHODS: This retrospective cohort study used the IBM MarketScan Commercial and Medicare database. Adults with AD who initiated dupilumab (first dispensation = index date) between March 28, 2017, and March 31, 2018, were identified and followed up until September 30, 2018, or disenrollment. Twelve months of continuous preindex enrollment were required to characterize baseline treatment history and comorbidities. Kaplan-Meier analysis was used to estimate dupilumab persistence at 6 and 12 months, assuming a 14-day injection frequency and a 30-day grace period. RESULTS: A total of 1963 adults were identified who initiated dupilumab (mean [SD] age 42.1 [15.7] years; 50.7% women; 49.8% with ≥1 atopic comorbidity). Baseline AD treatments included topical corticosteroids (81.6%), systemic corticosteroids (72.5%), and systemic immunosuppressants (22.8%). Dupilumab persistence (95% confidence interval) at 6 and 12 months was 91.9% (90.7%-93.2%) and 77.3% (75.0%-79.7%), respectively. Among 329 patients who discontinued dupilumab, the risk of reinitiation was 78.8% (95% confidence interval: 75.8%-81.7%) within an average of 4 months. CONCLUSION: Dupilumab persistence at 12 months was high, suggesting patient satisfaction with effectiveness, tolerability, and treatment regimen.


Assuntos
Anticorpos Monoclonais Humanizados/uso terapêutico , Dermatite Atópica/tratamento farmacológico , Terapia de Alvo Molecular , Adulto , Anticorpos Monoclonais Humanizados/farmacologia , Dermatite Atópica/diagnóstico , Dermatite Atópica/etiologia , Dermatite Atópica/metabolismo , Gerenciamento Clínico , Suscetibilidade a Doenças , Feminino , Humanos , Subunidade alfa de Receptor de Interleucina-4/antagonistas & inibidores , Subunidade alfa de Receptor de Interleucina-4/metabolismo , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Resultado do Tratamento
14.
J Formos Med Assoc ; 120(1 Pt 2): 429-442, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32564976

RESUMO

BACKGROUND/PURPOSE: Atopic dermatitis (AD) is a chronic inflammatory disease commonly seen in children and increasingly recognized in adults. With recent advances in the therapeutic development for AD, the Taiwanese Dermatological Association (TDA) established a committee to update the consensus for AD management in Taiwan. This report describes the 2020 updated consensus for the management of AD. METHODS: A panel of 11 core members was convened to review and discuss aspects of AD management and draft recommendation during the first two meetings. The 2015 TDA consensus and the 2017 European guideline, along with recent peer-reviewed articles, serve as the foundation for the update. In the third meeting, AD expert dermatologists selected on a national scale were invited to vote on the final statements. A total of 27 dermatologists attended the final meeting. The consensus was achieved when ratings of 7-9 (out of a total score of 9) accounted for ≥ 75% of the total votes. RESULTS: Consensus was achieved on the therapeutic options for AD by lines of treatment. A treatment algorithm was presented to illustrate the place of each modality in terms of basic care, acute disease control, and maintenance therapy. Special considerations for the pediatric population, as well as for women during pregnancy and lactation, are discussed. CONCLUSION: Topical corticosteroids with long-term emollient-based therapies remain the cornerstone of AD treatment. Systemic treatments are indicated when topical therapies and phototherapy fail to control the disease. The recent approval of dupilumab and emerging targeted therapies are expected to bring significant clinical benefit for patients whose disease is inadequately managed by existing options.


Assuntos
Dermatite Atópica , Grupo com Ancestrais do Continente Asiático , Consenso , Dermatite Atópica/tratamento farmacológico , Feminino , Humanos , Gravidez , Taiwan
15.
J Ethnopharmacol ; 266: 113397, 2021 Feb 10.
Artigo em Inglês | MEDLINE | ID: mdl-32971159

RESUMO

ETHNOPHARMACOLOGICAL RELEVANCE: Atopic dermatitis (AD) is a complex skin disease with highly heterogeneous inflammation, which ranks among the largest component of the nonfatal diseases worldwide. The medications currently used to treat AD primarily include antihistamines, vitamin D and anti-inflammatory drugs, etc. But, the usage of these drugs is usually accompanied by various side-effects. Formononetin (FMN), a natural active ingredient of Astragalus membranaceus (Fisch.) Bunge, decreases the AD relapse rate, reduces recurring severity incidence and resists the inflammation in the initial stage of AD. However, the underlying mechanism of FMN on repressing the development of AD is still unknown. AIM OF THE STUDY: To investigate the potential mechanism of FMN on relieving the initial responses of AD and elucidate its possible therapeutic targets in vivo and in vitro. MATERIALS AND METHODS: A fluorescein isothiocyanate (FITC)-induced mouse model of the initial stage of AD was established in vivo. Human keratinocytes (HaCaT) cells were co-stimulated with tumor necrosis factor alpha (TNF-α) and polyinosinic-polycytidylic acid (Poly(I:C)) in vitro. The production of thymic stromal lymphopoietin (TSLP) and immunoglobulin E (IgE) were detected by enzyme-linked immunosorbnent assay (ELISA). The protein expression was measured through immunohistochemistry and western blotting. The mRNA expression was examined by real-time quantitative polymerase chain reaction (RT-qPCR). The impact of TNF-α-induced protein 3 (TNFAIP3/A20) was reflected using its small interfering RNA (siRNA). The role of G protein-coupled estrogen receptor (GPER) was explored using its agonist (G1), antagonist (G15) or siRNA (siGPER) in vitro. RESULTS: We found that FMN upregulated the expression of A20 protein and mRNA in the initial stage of AD model, especially in the epithelial region of ear tissue, and inhibited the production of TSLP simultaneously. Consistently, FMN significantly upregulated A20 protein and its mRNA expression while reduced TSLP protein and its mRNA expression in vitro, and this effect could be antagonized by A20 siRNA (siA20). Moreover, compared with PPT (ERα agonist) and DPN (ERß agonist), G1 could significantly increase the expression of A20. In addition, compared with MPP (ERα antagonist) and PHTPP (ERß antagonist), G15 could markedly reduce the expression of A20. Furthermore, the effects of FMN on A20 were interfered by siGPER and G15 in vitro and in vivo. CONCLUSIONS: These results demonstrated that FMN attenuated AD by upregulating A20 expression via activation of GPER. This new strategy might have effective therapeutic potential for AD and other inflammatory disorders.


Assuntos
Dermatite Atópica/tratamento farmacológico , Inflamação/tratamento farmacológico , Isoflavonas/farmacologia , Proteína 3 Induzida por Fator de Necrose Tumoral alfa/genética , Animais , Citocinas/metabolismo , Dermatite Atópica/patologia , Modelos Animais de Doenças , Humanos , Inflamação/patologia , Queratinócitos/efeitos dos fármacos , Queratinócitos/patologia , Masculino , Camundongos , Camundongos Endogâmicos BALB C , Receptores Estrogênicos/metabolismo , Receptores Acoplados a Proteínas-G/metabolismo , Regulação para Cima/efeitos dos fármacos
16.
Mol Immunol ; 130: 104-112, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33309306

RESUMO

Atopic dermatitis is a severe, chronic relapsing inflammatory disease of the skin with family clustering. It is characterized into acute phase, which is dominated by T helper 2-type immune responses, and chronic phase, which is dominated by T helper 1-type immune responses. Studies have shown that 3,3'-diindolylmethane not only has antitumor effects but also can relieve symptoms of inflammatory diseases by inhibiting the nuclear factor-κB signaling pathway and regulating T cell differentiation. To study the effect of 3,3'-diindolylmethane on atopic dermatitis and the underlying mechanism, a mouse model of acute atopic dermatitis was established using 2,4-dinitrofluorobenzene. After intraperitoneal injection of 3,3'-diindolylmethane, skin erythema and edema in mice were significantly alleviated. Furthermore, 3,3'-diindolylmethane reduced immune activation, probably by inhibiting the secretion of thymic stromal lymphopoietin by keratinocytes. 3,3'-Diindolylmethane also promoted the differentiation of regulatory T cells and inhibited the activation of T helper 2 and T helper 17 cells to reduce atopic dermatitis-related immune responses. However, it showed no significant effect on the differentiation of T helper 1 cells. These results indicate that 3,3'-diindolylmethane has a significant inhibitory effect on T helper 2 cells in the acute phase of atopic dermatitis. Our findings may provide not only more insights into the pathological mechanism of AD, but also a new candidate medicine for it.


Assuntos
Diferenciação Celular/efeitos dos fármacos , Dermatite Atópica/tratamento farmacológico , Indóis/uso terapêutico , Linfócitos T/efeitos dos fármacos , Doença Aguda , Adulto , Animais , Diferenciação Celular/imunologia , Células Cultivadas , Dermatite Atópica/imunologia , Modelos Animais de Doenças , Feminino , Humanos , Indóis/farmacologia , Queratinócitos/efeitos dos fármacos , Queratinócitos/fisiologia , Ativação Linfocitária/efeitos dos fármacos , Camundongos , Camundongos Endogâmicos BALB C , Pele/efeitos dos fármacos , Pele/imunologia , Linfócitos T/fisiologia
17.
Arerugi ; 69(10): 979-988, 2020.
Artigo em Japonês | MEDLINE | ID: mdl-33310981

RESUMO

BACKGROUND: Dupilumab, an anti-IL (Interleukin) -4 receptorα mAb, inhibits IL-4/IL-13 signaling and is indicated for the treatment of inadequately controlled AD, asthma and CRSwNP because IL-4/IL-13 signaling is a key driver of type2/Th2 immune diseases (atopic/allergic diseases). As well as the above diseases, a therapeutic effect of dupilumab on PAR can be expected. We investigated the effect of dupilumab on PAR in severe AD patients with comorbid PAR. METHODS: Prospective observational study. 21 severe AD patients with PAR who started dupilumab were enrolled and we devided them into 2 groups: more than moderate group and less than moderate group. We investigated subjective symptoms, QOL scores, face scale, findings of nasal cavity and laboratory findings before start of therapy and 12 months later. RESULTS: In more than moderate group, significant improvements were observed in subjective symptoms (except a part), QOL scores (except a part), face scale and findings of nasal cavity. On the other hand, in less than moderate group, no improvement was observed in all items. Subjective symptom assessments were estimated lowlier than objective finding assessments. CONCLUSION: Dupilumab has a therapeutic effect on severe PAR in severe AD patients.


Assuntos
Anticorpos Monoclonais Humanizados/uso terapêutico , Dermatite Atópica , Dermatite Atópica/tratamento farmacológico , Humanos , Estudos Prospectivos , Qualidade de Vida
18.
Allergol. immunopatol ; 48(6): 753-762, nov.-dic. 2020. tab
Artigo em Inglês | IBECS | ID: ibc-199267

RESUMO

Histamine is a chemical mediator, released predominantly by tissue mast cells, circulating basophils, and neurons, which are activated in response to various immunological and non-immunological stimuli. Histamine has to bind to specific receptors to exert its physiological and pathophysiological functions. Endogenous histamine is the main mediator of the immediate allergic response, which moreover, performs other multiple functions, including regulation of gastric secretion, neurotransmission in the central nervous system, and immunomodulatory activity. The involvement of histamine in various disorders and the importance of receptors in the clinical features have relevant implications in clinical practice. Anti-H1 antihistamines contrast the histamine-dependent effects, mainly concerning nasal symptoms and cutaneous itching and wheal. Antihistamines are among the most prescribed drugs in pediatric care. This review updates the practical use of antihistamines in children and adolescents


No disponible


Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Antagonistas dos Receptores Histamínicos/farmacologia , Antagonistas dos Receptores Histamínicos/uso terapêutico , Antagonistas dos Receptores Histamínicos/classificação , Rinite Alérgica/tratamento farmacológico , Conjuntivite Alérgica/tratamento farmacológico , Urticária/tratamento farmacológico , Dermatite Atópica/tratamento farmacológico , Asma/tratamento farmacológico , Anafilaxia/tratamento farmacológico
19.
Allergol. immunopatol ; 48(6): 792-797, nov.-dic. 2020. tab, graf
Artigo em Inglês | IBECS | ID: ibc-199271

RESUMO

Atopic dermatitis (AD) is a chronic inflammatory skin disease characterized by relapsing eczema and pruritus. Until the development of Dupilumab, a new monoclonal antibody targeting IL-4 and IL-13 receptors, the current treatment of severe cases was based on immunosuppressant agents. Our main goal was to build a case series of five patients with severe atopic dermatitis, who were using immunosuppressive drugs with significant adverse effects and only partially controlled AD, and compare their symptoms, SCORAD index, treatment regimens, total and specific IgE, and blood cell count before and after the introduction of Dupilumab. SCORAD index and topical corticosteroids used on a daily basis had a significant decrease after 16 weeks of Dupilumab. Adverse effects were mild: conjunctivitis, local reaction and regional dermatosis. All patients with severe atopic dermatitis achieved better control of AD with Dupilumab than with immunosuppressive drugs. Adverse effects, secondary infections, total and specific IgE levels were greatly reduced


No disponible


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Dermatite Atópica/tratamento farmacológico , Anticorpos Monoclonais Humanizados/uso terapêutico , Índice de Gravidade de Doença , Resultado do Tratamento , Fatores de Tempo , Imunossupressores/uso terapêutico
20.
Dermatol Online J ; 26(10)2020 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-33147660

RESUMO

Owing to the evolving COVID-19 pandemic and emerging data regarding immunosuppressant therapies for inflammatory cutaneous diseases, dermatologists are being encouraged to reevaluate their patients' treatment regimens to minimize any potential risk of SARS-CoV-2 infection. This article includes an overview of the up-to-date international and U.S. treatment guidelines for psoriasis, atopic dermatitis, hidradenitis suppurativa, and acne/rosacea; it provides tables summarizing these resources to assist providers and patients in remaining updated regarding recommended treatment modifications during the pandemic (See Tables 1-4).


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Dermatite Atópica/tratamento farmacológico , Hidradenite Supurativa/tratamento farmacológico , Pneumonia Viral/epidemiologia , Psoríase/tratamento farmacológico , Rosácea/tratamento farmacológico , Produtos Biológicos/uso terapêutico , Infecções por Coronavirus/complicações , Infecções por Coronavirus/transmissão , Humanos , Imunossupressores , Internacionalidade , Pandemias , Pneumonia Viral/complicações , Pneumonia Viral/transmissão , Estados Unidos
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