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特应性皮炎治疗的新兴生物疗法。

Emerging Biologic Therapies for the Treatment of Atopic Dermatitis.

机构信息

Department of Dermatology, Unidade Local de Saúde de Santo António, Porto, Portugal.

Department of Dermatology, University Hospital of Zürich, Zürich, Switzerland.

出版信息

Drugs. 2024 Nov;84(11):1379-1394. doi: 10.1007/s40265-024-02095-4. Epub 2024 Oct 4.

Abstract

Atopic dermatitis (AD) is a prevalent inflammatory skin disease having a significant impact on patients' quality of life. Conventional treatments, including topical therapies and systemic immunosuppressants, often have limited efficacy and long-term safety concerns. Emerging biologic therapies target specific immune pathways implicated in AD pathogenesis, offering new therapeutic options in a disease known for its complex immune pathomechanisms. This review focuses on novel biologics under investigation, particularly those targeting specific immune pathways such as interleukin-4 (IL-4), IL-13, IL-22, IL-31, thymic stromal lymphopoietin (TSLP), and OX40-OX40L axis. Interleukin-4 and IL-13 inhibitors aim to reduce Th2-driven inflammation, while IL-22 inhibitors focus on restoring skin barrier function. Interleukin-31 inhibitors help alleviate pruritus, a major symptom in AD. OX40-OX40L pathway inhibitors can selectively suppress the activity of pathogenic T cells, without inducing significant immunosuppression. Bispecific antibodies targeting both IL-4 and IL-31 pathways are emerging as potential dual-action treatment for AD. Thymic stromal lymphopoietin inhibitors offer a novel strategy to control inflammation. While many of these therapies offer promising safety and efficacy profiles, long-term studies and real-world data are essential to confirm their lasting impact. This review highlights the potential of these emerging systemic therapies to continue transforming AD management and improve patient outcomes.

摘要

特应性皮炎(AD)是一种常见的炎症性皮肤疾病,对患者的生活质量有重大影响。传统的治疗方法,包括局部治疗和全身免疫抑制剂,通常疗效有限,且存在长期安全性问题。新兴的生物疗法针对 AD 发病机制中涉及的特定免疫途径,为这种以复杂免疫发病机制为特征的疾病提供了新的治疗选择。本综述重点介绍了正在研究中的新型生物制剂,特别是那些针对特定免疫途径的生物制剂,如白细胞介素 4(IL-4)、白细胞介素 13(IL-13)、白细胞介素 22(IL-22)、白细胞介素 31(IL-31)、胸腺基质淋巴细胞生成素(TSLP)和 OX40-OX40L 轴。IL-4 和 IL-13 抑制剂旨在减少 Th2 驱动的炎症,而 IL-22 抑制剂则专注于恢复皮肤屏障功能。IL-31 抑制剂有助于缓解 AD 的主要症状瘙痒。OX40-OX40L 通路抑制剂可以选择性地抑制致病性 T 细胞的活性,而不会引起明显的免疫抑制。同时靶向 IL-4 和 IL-31 通路的双特异性抗体作为 AD 的潜在双重作用治疗方法正在出现。胸腺基质淋巴细胞生成素抑制剂提供了一种控制炎症的新策略。虽然这些疗法中的许多都具有有前景的安全性和疗效特征,但长期研究和真实世界的数据对于确认它们的持久影响至关重要。本综述强调了这些新兴的全身性治疗方法在继续改变 AD 管理和改善患者预后方面的潜力。

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