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Peña-Corona SI, Gutiérrez-Ruiz SC, Echeverria MDLDC, Cortés H, González-Del Carmen M, Leyva-Gómez G. Advances in the treatment of autosomal recessive congenital ichthyosis, a look towards the repositioning of drugs. Front Pharmacol 2023; 14:1274248. [PMID: 38027029 PMCID: PMC10665491 DOI: 10.3389/fphar.2023.1274248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 10/11/2023] [Indexed: 12/01/2023] Open
Abstract
Autosomal recessive congenital ichthyoses (ARCI) are a skin pathology due to genetic causes characterized by a variable degree of desquamation, accompanied by erythema. The degree of symptoms is variable, different altered genes are involved, and the symptoms drastically affect patients' quality of life. Topical treatments are a first-choice strategy due to their ease of application and cost; however, enteral administration of retinoids offers greater efficacy, although with certain limitations. Despite the treatment alternatives, ARCI will persist throughout life, disabling people. Therefore, the search for new treatments always remains necessary. Especially repositioning drugs could be a short-term alternative to new affordable treatments for patients. Taking advantage of extensive knowledge of known drugs or biologics could ensure more accessible and possibly lower-cost treatments. This review briefly and concisely addresses possible repositioning strategies with drugs and biologics for ichthyosis.
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Affiliation(s)
- Sheila I. Peña-Corona
- Departamento de Farmacia, Facultad de Química, Universidad Nacional Autónoma de México, Ciudad de México, Mexico
| | | | | | - Hernán Cortés
- Laboratorio de Medicina Genómica, Departamento de Genómica, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Ciudad de Mexico, Mexico
| | | | - Gerardo Leyva-Gómez
- Departamento de Farmacia, Facultad de Química, Universidad Nacional Autónoma de México, Ciudad de México, Mexico
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2
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Lefferdink R, Rangel SM, Chima M, Ibler E, Pavel AB, Kim H, Wu B, Abu-Zayed H, Wu J, Jackson K, Singer G, Choate KA, Guttman-Yassky E, Paller AS. Secukinumab responses vary across the spectrum of congenital ichthyosis in adults. Arch Dermatol Res 2023; 315:305-315. [PMID: 35218370 PMCID: PMC10234080 DOI: 10.1007/s00403-022-02325-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 01/17/2022] [Accepted: 01/20/2022] [Indexed: 01/18/2023]
Abstract
IMPORTANCE Treatment of congenital ichthyoses primarily focuses on reversing skin scaling and is not pathogenesis based. Recent studies showed Th17 immune skewing, as in psoriasis, across the spectrum of ichthyosis, suggesting that targeting this pathway might broadly reduce disease severity. OBJECTIVE To determine whether secukinumab, an IL-17A inhibitor, can improve ichthyosis across several congenital ichthyosis subtypes. DESIGN Exploratory 16-week double-blind, randomized, placebo-controlled trial comparing secukinumab 300 mg every 4wks to placebo (1:1 randomization) in adults with the four major congenital ichthyosis subtypes (NCT03041038), followed by a 16-week open-label phase to evaluate response of the placebo-first group and a 20-week extension for safety. Significant differences in secukinumab- vs. placebo-treated subjects at Wk16 in the Ichthyosis Area Severity Index (IASI) score and lack of increased mucocutaneous bacterial and/or fungal infections were the co-primary efficacy and safety endpoints, respectively. SETTING Two tertiary referral centers: Northwestern University Feinberg School of Medicine, Chicago, and Mount Sinai Icahn School of Medicine, New York. PARTICIPANTS Twenty subjects ≥ 18 yo with genotype-confirmed epidermolytic ichthyosis, Netherton syndrome, lamellar ichthyosis, or congenital ichthyosiform erythroderma with at least moderate erythroderma. RESULTS IL-17A inhibition did not significantly reduce severity or increase mucocutaneous infections among the 18 who completed the 16-week double-blind phase. Five patients with 29-50% clinical improvement at Wk32 requested drug continuation. Th17-related biomarkers were not significantly reduced vs. baseline or placebo-treated levels. LIMITATIONS Small sample size; heterogeneous ichthyosis subsets. CONCLUSION IL-17 inhibition with secukinumab is safe, but not efficacious across the spectrum of adult ichthyoses. CLINICALTRIALS GOV REGISTRATION NUMBER NCT03041038; first posted on 02/02/2017.
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Affiliation(s)
- Rachel Lefferdink
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Stephanie M Rangel
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Margot Chima
- Department of Dermatology, The Laboratory of Inflammatory Skin Diseases, Icahn School of Medicine at Mount Sinai Medical Center, New York, NY, USA
| | - Erin Ibler
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Ana B Pavel
- Department of Dermatology, The Laboratory of Inflammatory Skin Diseases, Icahn School of Medicine at Mount Sinai Medical Center, New York, NY, USA
- Department of Biomedical Engineering, University of Mississippi, University, Oxford, MS, USA
| | - HeeJin Kim
- Department of Dermatology, The Laboratory of Inflammatory Skin Diseases, Icahn School of Medicine at Mount Sinai Medical Center, New York, NY, USA
| | - Benedict Wu
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Hajar Abu-Zayed
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Jianni Wu
- Department of Dermatology, The Laboratory of Inflammatory Skin Diseases, Icahn School of Medicine at Mount Sinai Medical Center, New York, NY, USA
| | - Kathryn Jackson
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Giselle Singer
- Department of Dermatology, The Laboratory of Inflammatory Skin Diseases, Icahn School of Medicine at Mount Sinai Medical Center, New York, NY, USA
| | - Keith A Choate
- Departments of Dermatology, Genetics, and Pathology, Yale University School of Medicine, New Haven, CT, USA
| | - Emma Guttman-Yassky
- Department of Dermatology, The Laboratory of Inflammatory Skin Diseases, Icahn School of Medicine at Mount Sinai Medical Center, New York, NY, USA.
| | - Amy S Paller
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
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3
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Hasbani DJ, Hamie L, Eid E, Tamer C, Abbas O, Kurban M. Treatments for Non-Syndromic Inherited Ichthyosis, Including Emergent Pathogenesis-Related Therapy. Am J Clin Dermatol 2022; 23:853-867. [PMID: 35960486 DOI: 10.1007/s40257-022-00718-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/25/2022] [Indexed: 11/27/2022]
Abstract
The term 'inherited ichthyosis' refers to a heterogeneous group of mendelian disorders of cornification that involve the integument with varying degrees of scaling. The management of ichthyosis poses a challenge for most physicians. Treatment options proposed in the literature include moisturizers, topical keratolytics, topical and systemic vitamin D analogues, and topical and systemic retinoids; however, some of these modalities are less reliable than others. Despite the therapeutic impasse imposed by the options above, the emergence of pathogenesis-based treatments along with novel gene therapies appear promising and hold the potential to halt or even revert disorders that arise from single genetic mutations, although research is still quite lacking in this domain. Hence, this review aims to highlight the various treatment modalities available for the management of the cutaneous manifestations of non-syndromic inherited ichthyosis, with an added emphasis on pathogenesis-targeted therapies.
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Affiliation(s)
- Divina Justina Hasbani
- Department of Dermatology, American University of Beirut Medical Center, Riad El Solh/Beirut 1107 2020, P.O. Box 11-0236, Beirut, Lebanon
| | - Lamiaa Hamie
- Department of Dermatology, Division of Pediatric Dermatology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Edward Eid
- Department of Dermatology, American University of Beirut Medical Center, Riad El Solh/Beirut 1107 2020, P.O. Box 11-0236, Beirut, Lebanon
| | - Christel Tamer
- Department of Radiology, American University of Beirut, Beirut, Lebanon
| | - Ossama Abbas
- Department of Dermatology, American University of Beirut Medical Center, Riad El Solh/Beirut 1107 2020, P.O. Box 11-0236, Beirut, Lebanon
| | - Mazen Kurban
- Department of Dermatology, American University of Beirut Medical Center, Riad El Solh/Beirut 1107 2020, P.O. Box 11-0236, Beirut, Lebanon.
- Department of Biochemistry and Molecular Genetics, American University of Beirut, Beirut, Lebanon.
- Division of Genomics and Translational Biomedicine, College of Health and Life Sciences, Hamad Bin Khalifa University, Doha, Qatar.
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Joosten MDW, Clabbers JMK, Jonca N, Mazereeuw-Hautier J, Gostyński AH. New developments in the molecular treatment of ichthyosis: review of the literature. Orphanet J Rare Dis 2022; 17:269. [PMID: 35840979 PMCID: PMC9287901 DOI: 10.1186/s13023-022-02430-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 06/30/2022] [Indexed: 11/24/2022] Open
Abstract
Ichthyosis covers a wide spectrum of diseases affecting the cornification of the skin. In recent years, new advances in understanding the pathophysiology of ichthyosis have been made. This knowledge, combined with constant development of pathogenesis-based therapies, such as protein replacement therapy and gene therapy, are rather promising for patients with inherited skin diseases. Several ongoing trials are investigating the potency of these new approaches and various studies have already been published. Furthermore, a lot of case series report that biological therapeutics are effective treatment options, mainly for Netherton syndrome and autosomal recessive congenital ichthyosis. It is expected that some of these new therapies will prove their efficacy and will be incorporated in the treatment of ichthyosis.
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Affiliation(s)
- M D W Joosten
- Department of Dermatology, The Netherlands and European Reference Network - Skin, Maastricht University Medical Center, Maastricht, The Netherlands.,GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, P. Debyelaan 25, 6229HX, Maastricht, The Netherlands
| | - J M K Clabbers
- Department of Dermatology, The Netherlands and European Reference Network - Skin, Maastricht University Medical Center, Maastricht, The Netherlands.,GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, P. Debyelaan 25, 6229HX, Maastricht, The Netherlands.,Department of Dermatology, Haga Hospital, The Hague, The Netherlands
| | - N Jonca
- Cell Biology and Cytology Laboratory, CNRS, Inserm, UPS, European Reference Network - Skin, University Hospital Center of Toulouse and Infinity, Federal Biology Institute, Toulouse University, Toulouse, France
| | - J Mazereeuw-Hautier
- Department of Dermatology, European Reference Network - Skin, University Hospital Center of Toulouse, Toulouse, France
| | - A H Gostyński
- Department of Dermatology, The Netherlands and European Reference Network - Skin, Maastricht University Medical Center, Maastricht, The Netherlands. .,GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, P. Debyelaan 25, 6229HX, Maastricht, The Netherlands.
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Murata T, Honda T, Mostafa A, Kabashima K. Stratum corneum as polymer sheet: concept and cornification processes. Trends Mol Med 2022; 28:350-359. [PMID: 35337733 DOI: 10.1016/j.molmed.2022.02.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 02/20/2022] [Accepted: 02/22/2022] [Indexed: 12/12/2022]
Abstract
The skin barrier protects our body from external insults and water loss through a specialized layer, the stratum corneum. The stratum corneum, an accumulation of dead keratinocytes (corneocytes), comprises lipids and supporting cell bodies. We propose a framework of lipid-filled polymer sheet of corneocytes, a unique structure that achieves flexibility and robustness, updating the rigid image of the historical bricks-and-mortar model. The polymerization of polymer sheet (cornification) by cell death of keratinocytes (corneoptosis) is delicately and dynamically controlled by cytoplasmic calcium ion and pH. Understanding the structure and formation of the stratum corneum can lead to better treatments for skin diseases and a better understanding of the evolution of the stratum corneum.
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Affiliation(s)
- Teruasa Murata
- Department of Dermatology, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
| | - Tetsuya Honda
- Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Alshimaa Mostafa
- Department of Dermatology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Kenji Kabashima
- Department of Dermatology, Graduate School of Medicine, Kyoto University, Kyoto, Japan; Singapore Immunology Network (SIgN) and Skin Research Institute of Singapore (SRIS), Agency for Science, Technology and Research (A*STAR), Biopolis, Singapore
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6
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Akiyama M. Ichthyosis Scoring System-A Powerful Tool in the Era of Immune Pathway-Targeted Therapies for Ichthyosis. JAMA Dermatol 2022; 158:354-356. [PMID: 35171196 DOI: 10.1001/jamadermatol.2021.5342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Masashi Akiyama
- Department of Dermatology, Nagoya University Graduate School of Medicine, Tsurumai-cho, Showa-ku, Nagoya, Aichi, Japan
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7
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Onoufriadis A, McGrath JA. ESDR 50th Anniversary Lecture summary: The past and future of rare skin disease research/therapy. J Invest Dermatol 2022; 142:1010-1014. [DOI: 10.1016/j.jid.2021.11.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 11/16/2021] [Accepted: 11/18/2021] [Indexed: 10/19/2022]
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Onoufriadis A, Proudfoot LE, Ainali C, Torre D, Papanikolaou M, Rayinda T, Rashidghamat E, Danarti R, Mellerio JE, Ma'ayan A, McGrath JA. Transcriptomic profiling of recessive dystrophic epidermolysis bullosa wounded skin highlights drug repurposing opportunities to improve wound healing. Exp Dermatol 2021; 31:420-426. [PMID: 34694680 DOI: 10.1111/exd.14481] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 10/18/2021] [Accepted: 10/22/2021] [Indexed: 12/26/2022]
Abstract
Chronic wounds present a major disease burden in people with recessive dystrophic epidermolysis bullosa (RDEB), an inherited blistering skin disorder caused by mutations in COL7A1 encoding type VII collagen, the major component of anchoring fibrils at the dermal-epidermal junction. Treatment of RDEB wounds is mostly symptomatic, and there is considerable unmet need in trying to improve and accelerate wound healing. In this study, we defined transcriptomic profiles and gene pathways in RDEB wounds and compared these to intact skin in RDEB and healthy control subjects. We then used a reverse transcriptomics approach to discover drugs or compounds, which might restore RDEB wound profiles towards intact skin. Differential expression analysis identified >2000 differences between RDEB wounds and intact skin, with RDEB wounds displaying aberrant cytokine-cytokine interactions, Toll-like receptor signalling, and JAK-STAT signalling pathways. In-silico prediction for compounds that reverse gene expression signatures highlighted methotrexate as a leading candidate. Overall, this study provides insight into the molecular profiles of RDEB wounds and underscores the possible clinical value of reverse transcriptomics data analysis in RDEB, and the potential of this approach in discovering or repurposing drugs for other diseases.
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Affiliation(s)
- Alexandros Onoufriadis
- St John's Institute of Dermatology, School of Basic and Medical Biosciences, King's College London, London, UK
| | - Laura E Proudfoot
- St John's Institute of Dermatology, School of Basic and Medical Biosciences, King's College London, London, UK
| | | | - Denis Torre
- Department of Pharmacological Sciences, Mount Sinai Center for Bioinformatics, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
| | - Maria Papanikolaou
- St John's Institute of Dermatology, School of Basic and Medical Biosciences, King's College London, London, UK
| | - Tuntas Rayinda
- St John's Institute of Dermatology, School of Basic and Medical Biosciences, King's College London, London, UK.,Department of Dermatology and Venereology, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada/Dr. Sardjito Hospital, Yogyakarta, Indonesia
| | - Ellie Rashidghamat
- St John's Institute of Dermatology, School of Basic and Medical Biosciences, King's College London, London, UK
| | - Retno Danarti
- Department of Dermatology and Venereology, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada/Dr. Sardjito Hospital, Yogyakarta, Indonesia
| | - Jemima E Mellerio
- St John's Institute of Dermatology, School of Basic and Medical Biosciences, King's College London, London, UK
| | - Avi Ma'ayan
- Department of Pharmacological Sciences, Mount Sinai Center for Bioinformatics, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
| | - John A McGrath
- St John's Institute of Dermatology, School of Basic and Medical Biosciences, King's College London, London, UK
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Jiang X, Wang H, Lee M, Lin Z. Epidermolysis Bullosa Pruriginosa Treated With Baricitinib. JAMA Dermatol 2021; 157:1243-1244. [PMID: 34468689 DOI: 10.1001/jamadermatol.2021.3174] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Xingyuan Jiang
- Department of Dermatology, Peking University First Hospital, Beijing Key Laboratory of Molecular Diagnosis on Dermatoses and National Clinical Research Center for Skin and Immune Diseases, Beijing, China
| | - Huijun Wang
- Department of Dermatology, Peking University First Hospital, Beijing Key Laboratory of Molecular Diagnosis on Dermatoses and National Clinical Research Center for Skin and Immune Diseases, Beijing, China
| | - Mingyang Lee
- Department of Dermatology, Peking University First Hospital, Beijing Key Laboratory of Molecular Diagnosis on Dermatoses and National Clinical Research Center for Skin and Immune Diseases, Beijing, China
| | - Zhimiao Lin
- Department of Dermatology, Peking University First Hospital, Beijing Key Laboratory of Molecular Diagnosis on Dermatoses and National Clinical Research Center for Skin and Immune Diseases, Beijing, China
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10
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Petrova E, Hovnanian A. Advances in understanding of Netherton syndrome and therapeutic implications. Expert Opin Orphan Drugs 2020. [DOI: 10.1080/21678707.2020.1857724] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Evgeniya Petrova
- Laboratory of genetic skin diseases, Université de Paris, Imagine Institute, INSERM UMR1163, Paris, France
| | - Alain Hovnanian
- Laboratory of genetic skin diseases, Université de Paris, Imagine Institute, INSERM UMR1163, Paris, France
- Departement of Genetics, AP-HP, Hôpital Necker-Enfants Malades, Paris, France
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