Department of Dermatology, Unidade Local de Saúde de Santo António, Porto, Portugal.
Department of Dermatology, University Hospital of Zürich, Zürich, Switzerland.
Drugs. 2024 Nov;84(11):1379-1394. doi: 10.1007/s40265-024-02095-4. Epub 2024 Oct 4.
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.
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。