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Hagino T, Onda M, Saeki H, Fujimoto E, Kanda N. Effects of Tralokinumab on Clinical and Laboratory Indexes in Atopic Dermatitis: A 24-Week Real-World Study. Dermatitis 2024. [PMID: 39361494 DOI: 10.1089/derm.2024.0323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/05/2024]
Abstract
Background: Tralokinumab, a monoclonal anti-IL-13 antibody, is approved for treating atopic dermatitis (AD). Real-world data on its effectiveness and safety are limited. Objective: To evaluate the real-world effectiveness and safety of tralokinumab and the transition of laboratory indexes during 24-week treatment for AD patients. Methods: This retrospective study included 104 patients with moderate-to-severe AD treated with tralokinumab 300 mg every 2 weeks after primary 600 mg. Clinical and laboratory indexes were assessed until week 24. Results: At week 24, achievement rates of Eczema Area and Severity Index 75 (EASI 75), EASI 90, and investigator's global assessment 0 out of 1 in systemic therapy-naïve patients, 83.3%, 72.2%, and 44.4%, respectively, were higher than those in systemic therapy-experienced patients, 46.7%, 20.0%, and 6.7%, respectively. Serum levels of immunoglobulin E (IgE), thymus and activation-regulated chemokine (TARC), and lactate dehydrogenase (LDH) significantly decreased at week 24, whereas neutrophil-to-lymphocyte ratio (NLR) and systemic inflammation response index (SIRI) significantly decreased at week 12 from baseline. Twenty-nine patients (27.9%) experienced mild treatment-emergent adverse events. Conclusions: Tralokinumab treatment showed prosperous therapeutic effects and good tolerability in real-world practice for AD, with higher effectiveness in patients without prior systemic therapy compared with those with prior systemic therapy. Tralokinumab treatment significantly decreased clinical and laboratory indexes, EASI, Peak Pruritus-Numerical Rating Scale, IgE, TARC, LDH, NLR, and SIRI.
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Affiliation(s)
- Teppei Hagino
- From the Department of Dermatology, Nippon Medical School Chiba Hokusoh Hospital, Inzai, Japan
| | - Marina Onda
- From the Department of Dermatology, Nippon Medical School Chiba Hokusoh Hospital, Inzai, Japan
| | - Hidehisa Saeki
- Department of Dermatology, Nippon Medical School, Tokyo, Japan
| | | | - Naoko Kanda
- From the Department of Dermatology, Nippon Medical School Chiba Hokusoh Hospital, Inzai, Japan
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2
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Lapp T, Mann C, Jakob T, Reinhard T, Maier PC. Atopic Keratoconjunctivitis: Pathophysiology, Clinic, and Potential New Therapeutic Concepts. Klin Monbl Augenheilkd 2024; 241:607-618. [PMID: 38604222 DOI: 10.1055/a-2244-2885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2024]
Abstract
Atopic dermatitis (AD) is a chronic recurrent inflammatory skin disease with a bipolar age distribution in childhood, adolescence and middle adulthood. Up to 50% of AD patients show ocular involvement, which can be potentially sight threatening. Clinically, the majority of cases present with atopic blepharo(kerato)conjunctivitis or atopic keratoconjunctivitis (AKC); other clinical variants from this group of inflammatory ocular surface diseases are keratoconjunctivitis vernalis in childhood and adolescence and allergic conjunctivitis. In addition to the aforementioned blepharitis, keratitis and conjunctivitis, AD is also associated with eyelid involvement with subsequent eyelid malposition, limbal insufficiency with the development of pseudopterygia, (chronic) cicatrizing conjunctivitis with symblephara formation and fornix shortening, as well as ocular surface malignancies such as conjunctival intraepithelial neoplasia (CIN) and squamous cell carcinoma. In addition, an association with AD or AKC has been described for keratoconus. Whereas the therapy of AD in dermatology has made revolutionary advances in recent years through the use of biologicals, the primary use of these biologicals in ophthalmological complications is still very hesitant. Treatment here is often provided using topical steroids and calcineurin inhibitors. The following article summarises recent developments in basic and clinical dermatological research and discusses them in the context of current concepts for ophthalmological therapy.
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Affiliation(s)
- Thabo Lapp
- Klinik für Augenheilkunde, Universitätsklinikum Freiburg, Deutschland
- Augenzentrum am St. Franziskus Hospital, Münster, Deutschland
| | - Caroline Mann
- Haut- und Poliklinik, Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Deutschland
| | - Thilo Jakob
- Klinik für Dermatologie und Allergologie, Universitätsklinikum Gießen und Marburg, Gießen, Deutschland
| | - Thomas Reinhard
- Klinik für Augenheilkunde, Universitätsklinikum Freiburg, Deutschland
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Kido-Nakahara M, Onozuka D, Izuhara K, Saeki H, Nunomura S, Takenaka M, Matsumoto M, Kataoka Y, Fujimoto R, Kaneko S, Morita E, Tanaka A, Saito R, Okano T, Miyagaki T, Aoki N, Nakajima K, Ichiyama S, Tonomura K, Nakagawa Y, Tamagawa-Mineoka R, Masuda K, Takeichi T, Akiyama M, Ishiuji Y, Katsuta M, Kinoshita Y, Tateishi C, Yamamoto A, Morita A, Matsuda-Hirose H, Hatano Y, Kawasaki H, Fukushima-Nomura A, Ohtsuki M, Kamiya K, Kabata Y, Abe R, Mitsui H, Kawamura T, Tsuji G, Furue M, Katoh N, Nakahara T. Exploring patient background and biomarkers associated with the development of dupilumab-associated conjunctivitis and blepharitis. Allergol Int 2024; 73:332-334. [PMID: 38151410 DOI: 10.1016/j.alit.2023.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 11/23/2023] [Accepted: 12/04/2023] [Indexed: 12/29/2023] Open
Affiliation(s)
- Makiko Kido-Nakahara
- Department of Dermatology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Daisuke Onozuka
- Department of Oral Microbe Control, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Kenji Izuhara
- Division of Medical Biochemistry, Department of Biomolecular Sciences, Saga Medical School, Saga, Japan
| | - Hidehisa Saeki
- Department of Dermatology, Nippon Medical School, Tokyo, Japan
| | - Satoshi Nunomura
- Division of Medical Biochemistry, Department of Biomolecular Sciences, Saga Medical School, Saga, Japan
| | - Motoi Takenaka
- Department of Dermatology, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Mai Matsumoto
- Department of Dermatology, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Yoko Kataoka
- Department of Dermatology, Osaka Habikino Medical Center, Osaka, Japan
| | - Rai Fujimoto
- Department of Dermatology, Osaka Habikino Medical Center, Osaka, Japan
| | - Sakae Kaneko
- Department of Dermatology, Shimane University Faculty of Medicine, Shimane, Japan
| | - Eishin Morita
- Department of Dermatology, Shimane University Faculty of Medicine, Shimane, Japan
| | - Akio Tanaka
- Department of Dermatology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Ryo Saito
- Department of Dermatology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Tatsuro Okano
- Department of Dermatology, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Tomomitsu Miyagaki
- Department of Dermatology, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Natsuko Aoki
- Department of Dermatology, Kochi Medical School, Kochi, Japan
| | - Kimiko Nakajima
- Department of Dermatology, Kochi Medical School, Kochi, Japan
| | - Susumu Ichiyama
- Department of Dermatology, Nippon Medical School, Tokyo, Japan
| | - Kyoko Tonomura
- Department of Dermatology, Course of Integrated Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Yukinobu Nakagawa
- Department of Dermatology, Course of Integrated Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Risa Tamagawa-Mineoka
- Department of Dermatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Koji Masuda
- Department of Dermatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Takuya Takeichi
- Department of Dermatology, Nagoya University Graduate School of Medicine, Aichi, Japan
| | - Masashi Akiyama
- Department of Dermatology, Nagoya University Graduate School of Medicine, Aichi, Japan
| | - Yozo Ishiuji
- Department of Dermatology, The Jikei University School of Medicine, Tokyo, Japan
| | - Michie Katsuta
- Department of Dermatology, The Jikei University School of Medicine, Tokyo, Japan
| | - Yuki Kinoshita
- Department of Dermatology, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Chiharu Tateishi
- Department of Dermatology, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Aya Yamamoto
- Department of Geriatric and Environmental Dermatology, Nagoya City University Graduate School of Medical Sciences, Aichi, Japan
| | - Akimichi Morita
- Department of Geriatric and Environmental Dermatology, Nagoya City University Graduate School of Medical Sciences, Aichi, Japan
| | | | - Yutaka Hatano
- Department of Dermatology, Faculty of Medicine, Oita University, Oita, Japan
| | - Hiroshi Kawasaki
- Department of Dermatology, School of Medicine, Keio University, Tokyo, Japan
| | | | - Mamitaro Ohtsuki
- Department of Dermatology, Jichi Medical University, Tochigi, Japan
| | - Koji Kamiya
- Department of Dermatology, Jichi Medical University, Tochigi, Japan
| | - Yudai Kabata
- Division of Dermatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Riichiro Abe
- Division of Dermatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Hiroshi Mitsui
- Department of Dermatology, Faculty of Medicine, University of Yamanashi, Yamanashi, Japan
| | - Tatsuyoshi Kawamura
- Department of Dermatology, Faculty of Medicine, University of Yamanashi, Yamanashi, Japan
| | - Gaku Tsuji
- Department of Dermatology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Masutaka Furue
- Department of Dermatology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Norito Katoh
- Department of Dermatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Takeshi Nakahara
- Department of Dermatology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
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Li D, Ou Q, Shen Q, Lu MM, Xu JY, Jin C, Gao F, Wang J, Zhang J, Zhang J, Li J, Lu L, Xu GT, Tian H. Subconjunctival injection of human umbilical cord mesenchymal stem cells alleviates experimental allergic conjunctivitis via regulating T cell response. Stem Cell Res Ther 2023; 14:281. [PMID: 37784129 PMCID: PMC10546642 DOI: 10.1186/s13287-023-03484-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 08/29/2023] [Indexed: 10/04/2023] Open
Abstract
BACKGROUND T helper 2 (Th2) cells are thought to play critical roles in allergic conjunctivitis (AC). They release inflammatory cytokines to promote an allergic response in AC. Due to individual heterogeneity and long-term chronic management, current therapies do not always effectively control AC. Mesenchymal stem cells (MSCs) have been shown to be effective in treating allergy-related disorders, but it is unclear how exactly the Th2-mediated allergic response is attenuated. This study aims to elucidate the therapeutic effect and mechanism of the human umbilical cord MSCs (hUCMSCs) in a mouse model of experimental AC (EAC). METHODS A mouse EAC model was established by inoculating short ragweed (SRW) pollen. After the SRW pollen challenge, the mice received a single subconjunctival or tail vein injection of 2 × 106 hUCMSCs, or subconjunctival injection of hUCMSCs conditioned medium (hUCMSC-CM), and dexamethasone eye drops was used as positive control; subsequent scratching behavior and clinical symptoms were assessed. Immunostaining and flow cytometry were carried out to show allergic reactions and the activation of CD4 + T cell subsets in the conjunctiva and cervical lymph nodes (CLNs). Gene expression was determined by RNA-seq and further verified by qRT-PCR and Western blot. Co-culture assays were performed to explore the regulatory role of hUCMSCs in the differentiation of CD4 + naive T cells (Th0) into Th2 cells. RESULTS Subconjunctival administration of hUCMSCs resulted in fewer instances of scratching and lower inflammation scores in EAC mice compared to the tail vein delivery, hUCMSC-CM and control groups. Subconjunctival administration of hUCMSCs reduced the number of activated mast cells and infiltrated eosinophils in the conjunctiva, as well as decreased the number of Th2 cells in CLNs. After pretreatment with EAC mouse serum in vitro to mimic the in vivo milieu, hUCMSCs were able to inhibit the differentiation of Th0 into Th2 cells. Further evidence demonstrated that repression of Th2 cell differentiation by hUCMSCs is mediated by CRISPLD2 through downregulation of STAT6 phosphorylation. Additionally, hUMCSCs were able to promote the differentiation of Th0 cells into regulatory T cells in CLNs of EAC mice. CONCLUSIONS Subconjunctival injection of hUCMSCs suppressed the Th2-allergic response and alleviated clinical symptoms. This study provides not only a potential therapeutic target for the treatment of AC but also other T cell-mediated diseases.
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Affiliation(s)
- Dongli Li
- Department of Ophthalmology of Tongji Hospital, Laboratory of Clinical and Visual Sciences of Tongji Eye Institute, School of Medicine, Tongji University, 389 Xincun Road, Shanghai, 200065, China
| | - Qingjian Ou
- Department of Ophthalmology of Tongji Hospital, Laboratory of Clinical and Visual Sciences of Tongji Eye Institute, School of Medicine, Tongji University, 389 Xincun Road, Shanghai, 200065, China
| | - Qi Shen
- Department of Ophthalmology of Tongji Hospital, Laboratory of Clinical and Visual Sciences of Tongji Eye Institute, School of Medicine, Tongji University, 389 Xincun Road, Shanghai, 200065, China
| | - Michael Mingze Lu
- Department of Ophthalmology of Tongji Hospital, Laboratory of Clinical and Visual Sciences of Tongji Eye Institute, School of Medicine, Tongji University, 389 Xincun Road, Shanghai, 200065, China
| | - Jing-Ying Xu
- Department of Ophthalmology of Tongji Hospital, Laboratory of Clinical and Visual Sciences of Tongji Eye Institute, School of Medicine, Tongji University, 389 Xincun Road, Shanghai, 200065, China
| | - Caixia Jin
- Department of Ophthalmology of Tongji Hospital, Laboratory of Clinical and Visual Sciences of Tongji Eye Institute, School of Medicine, Tongji University, 389 Xincun Road, Shanghai, 200065, China
| | - Furong Gao
- Department of Ophthalmology of Tongji Hospital, Laboratory of Clinical and Visual Sciences of Tongji Eye Institute, School of Medicine, Tongji University, 389 Xincun Road, Shanghai, 200065, China
| | - Juan Wang
- Department of Ophthalmology of Tongji Hospital, Laboratory of Clinical and Visual Sciences of Tongji Eye Institute, School of Medicine, Tongji University, 389 Xincun Road, Shanghai, 200065, China
| | - Jingfa Zhang
- Department of Ophthalmology, Shanghai General Hospital (Shanghai First People's Hospital), Shanghai Jiao Tong University, Shanghai, 200080, China
| | - Jieping Zhang
- Department of Ophthalmology of Tongji Hospital, Laboratory of Clinical and Visual Sciences of Tongji Eye Institute, School of Medicine, Tongji University, 389 Xincun Road, Shanghai, 200065, China
- Department of Physiology and Pharmacology, TUSM, Shanghai, 200092, China
| | - Jiao Li
- Department of Ophthalmology of Tongji Hospital, Laboratory of Clinical and Visual Sciences of Tongji Eye Institute, School of Medicine, Tongji University, 389 Xincun Road, Shanghai, 200065, China
| | - Lixia Lu
- Department of Ophthalmology of Tongji Hospital, Laboratory of Clinical and Visual Sciences of Tongji Eye Institute, School of Medicine, Tongji University, 389 Xincun Road, Shanghai, 200065, China.
| | - Guo-Tong Xu
- Department of Ophthalmology of Tongji Hospital, Laboratory of Clinical and Visual Sciences of Tongji Eye Institute, School of Medicine, Tongji University, 389 Xincun Road, Shanghai, 200065, China.
- Department of Physiology and Pharmacology, TUSM, Shanghai, 200092, China.
- The Collaborative Innovation Center for Brain Science, Tongji University, Shanghai, 200092, China.
| | - Haibin Tian
- Department of Ophthalmology of Tongji Hospital, Laboratory of Clinical and Visual Sciences of Tongji Eye Institute, School of Medicine, Tongji University, 389 Xincun Road, Shanghai, 200065, China.
- Department of Physiology and Pharmacology, TUSM, Shanghai, 200092, China.
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5
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Cavuoto KM, Galor A, Zhu AY. Role of the ocular surface microbiome in allergic eye diseases. Curr Opin Allergy Clin Immunol 2023; 23:376-382. [PMID: 37459276 DOI: 10.1097/aci.0000000000000930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
PURPOSE OF REVIEW The purpose of this review is to provide an update on emerging literature on the role of the ocular surface microbiome (OSM) in allergic eye diseases. RECENT FINDINGS Findings in the literature suggest that the ocular surface microbiome plays a role in the pathophysiology and course of allergic disease of the ocular surface. SUMMARY Knowledge regarding the role of the ocular surface microbiome in allergic disease is important to guide development of targets for future therapeutic interventions.
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Affiliation(s)
- Kara M Cavuoto
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine
| | - Anat Galor
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine
- Miami Veterans Administration Medical Center, Miami, Florida, USA
| | - Angela Y Zhu
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine
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Bruschi G, Ghiglioni DG, Cozzi L, Osnaghi S, Viola F, Marchisio P. Vernal Keratoconjunctivitis: A Systematic Review. Clin Rev Allergy Immunol 2023; 65:277-329. [PMID: 37658939 PMCID: PMC10567967 DOI: 10.1007/s12016-023-08970-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/03/2023] [Indexed: 09/05/2023]
Abstract
Vernal keratoconjunctivitis (VKC) is a chronic, bilateral corneal and conjunctival problem which typically presents in young individuals. VKC is characterized by itching, photophobia, white mucous discharge, lacrimation, foreign body sensation, and pain due to corneal involvement of shield ulcers. Vernal keratoconjunctivitis is categorized within ocular diseases. The diagnosis is clinical, as no sure biomarkers pathognomonic of the disease have yet been identified. The VKC therapy relies on different types of drugs, from antihistamines and topical steroids to cyclosporine or tacrolimus eye drops. In extremely rare cases, there is also the need for surgical treatment for the debridement of ulcers, as well as for advanced glaucoma and cataracts, caused by excessive prolonged use of steroid eye drops. We performed a systematic review of the literature, according to PRISMA guideline recommendations. We searched the PubMed database from January 2016 to June 2023. Search terms were Vernal, Vernal keratoconjunctivitis, and VKC. We initially identified 211 articles. After the screening process, 168 studies were eligible according to our criteria and were included in the review. In this study, we performed a systematic literature review to provide a comprehensive overview of currently available diagnostic methods, management of VKC, and its treatments.
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Affiliation(s)
| | - Daniele Giovanni Ghiglioni
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano, Via della Commenda 9, 20122, Milan, Italy.
| | - Laura Cozzi
- Università degli Studi di Milano, Milan, Italy
| | - Silvia Osnaghi
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano, Via della Commenda 9, 20122, Milan, Italy
| | - Francesco Viola
- Università degli Studi di Milano, Milan, Italy
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano, Via della Commenda 9, 20122, Milan, Italy
| | - Paola Marchisio
- Università degli Studi di Milano, Milan, Italy
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano, Via della Commenda 9, 20122, Milan, Italy
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