A macrolactam inhibitor of T helper type 1 and T helper type 2 cytokine biosynthesis for topical treatment of inflammatory skin diseases

Toxicological effects of nickel chloride on the cytokine mRNA expression and protein levels in intestinal mucosal immunity of broilers

The purpose of this study was to examine the toxicological effects of nickel chloride (NiCl2 ; 300, 600, and 900 mg kg(-1) diet) on the cytokine mRNA expression and protein levels in the intestinal mucosa and cecal tonsil, and on the ileac and cecal tonsil T cells in broilers by the methods of qRT-PCR, flow cytometry and ELISA for 42 days. Results showed that the IL-2, IL-6, IL-10, IL-17, IFN-γ, and TNF-α (LITAF) cytokine mRNA expression and protein levels were lower (P < 0.05 or P < 0.01) and the percentages of T-cell subsets were also lower in the 300, 600, and 900 mg kg(-1) groups than in the control group. It was concluded that dietary NiCl2 in excess of 300 mg kg(-1) could reduce cytokine mRNA expression and protein levels in the intestinal mucosa and cecal tonsil, and the percentages of ileac and cecal tonsil T-cell subsets. Decreasing in cytokine mRNA expression and protein levels of intestinal mucosa and cecal tonsil induced by NiCl2 was closely related to the reduction of T-cell population. Thus, the abnormal expression of these cytokines impacts the intestinal mucosal immune function by the pathways of reducing of lymphocyte population and activation. Also, this study first proved that NiCl2 at higher levels has the toxicological effects on intestinal mucosal immunity.

Tacrolimus: 10 years of successful clinical application

Tacrolimus (FK506) is the first drug from the new class of drugs - calcineurin inhibitors. It has a great potential and can change the current approaches to treatment of different dermatoses. Topical forms of Tacrolimus are activated due to the effect on T-lymphocyte signal transduction, and they also inhibit gene transcription. As a result, the T-cell response to antigens is alleviated. Percutaneous absorption of Tacrolimus in affection foci is higher than in healthy skin. Due to this a smaller amount of the drug is absorbed by the skin as long as the skin is healed. Systemic absorption of Tacrolimus is low in the course of treatment. The maximum clinical experience has been gained in the field of applying Tacrolimus for treatment of atopic dermatitis. In a number of clinical studies, 0.03-0.3% Tacrolimus ointment efficiently reduced the severity of symptoms and course of atopic dermatitis in adults and children. Moreover, topical treatment with Tacrolimus did not involve any substantial toxic effects. The patients most often complained of local irritations in the area where the ointment was applied, which were transient by nature and did not demand the drug withdrawal. Today Tacrolimus is a valuable and safer alternative to glucocorticosteroids for treatment of atopic dermatitis. It can also be used for treating other dermatoses, which demands additional all-round examination.

FLT3 inhibitors for the treatment of autoimmune disease

BACKGROUND

Autoimmune diseases encompass a broad range of illnesses with a variety of underlying causes, some of which are known and some of which remain elusive.

OBJECTIVE

The focus of this review will be on describing the development of a new type of therapy that could potentially treat T cell-mediated autoimmune diseases. Unlike traditional therapies, which have primarily focused on suppressing T cells directly, targeting the step of antigen presentation may allow a less toxic therapy in which autoimmunity is lessened without compromising the entire immune system. This review will outline the science behind the development of the therapy, the roles of dendritic cells in generating autoimmune disease, and the function of the FLT3 receptor in this process.

Therapeutic potential of macrolide immunosuppressants in dermatology

Dermatologists are frequently presented with inflammatory dermatoses that are responsive to treatment with immunomodulating drugs. Corticosteroids, particularly when applied topically, have been the mainstay of treatment in the past. Their undoubted efficacy, however, has been undermined by problems with repeated use including tachyphylaxis and side effects such as skin atrophy and hypertension. Macrolide immunosuppressive drugs, originally used for prophylaxis of organ transplant rejection, have been shown to be effective in the treatment of inflammatory dermatoses. The original drugs used in dermatology in this class have their own limitations including poor absorption when used topically and their distinct side-effect profiles. A search for other immunosuppressive macrolide antibiotics has led to the development of new agents, which have enhanced profiles for the treatment of skin disease. This review discusses the main dermatoses that may be targeted by this class of drugs and summarises the topical and systemic macrolides either currently in use, in clinical trials or preclinical development.

Hydrating effects of a corticoid oil formulation and its vehicle on human skin

Factors in the treatment of atopic dermatitis include restoring skin moisture and reducing inflammation. This study evaluated a corticoid oil formulation and its components with respect to their skin hydration potential. Ten healthy Caucasians were enrolled. Five test sites on the left and right forearm of each subject were tested: one site served as a normal skin control (without treatment), whereas four were wetted by spraying distilled water (approximately 0.1 ml) over a 3-cm2 skin surface area, and spraying was repeated every 5 min for a total of three applications. Five minutes after the final application, 0.2 ml of the corticoid oil formulation, moisturizing vehicle, and plain peanut oil were applied to each pre-designated site (3 cm2); one site was kept as a blank control (water saturation only). Thirty minutes later, test sites were gently wiped with paper tissues, and visual scoring, transepidermal water loss (TEWL), and capacitance were recorded and repeated at 2 and 3 h. The corticoid oil formulation, plain peanut oil, and moisturizing vehicle significantly increased skin hydration 30 min after each single application, with no statistically significant difference among the treatments at any point. The corticoid oil formulation and plain peanut oil slightly but not significantly elevated TEWL 30 min after application. The results support intuitive dermatologic judgment of advising patients to apply moisturizing medicaments after bathing.

Tacrolimus: a review of its use for the management of dermatoses

The newly developed immunomodulator tacrolimus (FK506) is the first of a new class of agents that have enormous potential to change the way that dermatoses are treated and managed. Tacrolimus has been found to be active in a topical formulation with the latter exerting its effects by acting on the signal transduction pathways inside T cells and inhibiting gene transcription. The result is decreased responsiveness of T cells to antigens. Percutaneous absorption of tacrolimus is higher in diseased skin as opposed to healthy skin and, therefore, the drug will be taken in at progressively lower quantities as lesions heal. There is limited systemic absorption of tacrolimus over the course of therapy. The most extensive experience with tacrolimus has been in treating atopic dermatitis. In numerous trials, tacrolimus ointment 0.03-0.3% has shown to be effective in reducing the symptoms and severity of atopic dermatitis in adults and the paediatric population. Furthermore, there have been no significant toxic effects associated with topical therapy with tacrolimus. The most common complaint is that of local irritation after applying the ointment. This is generally transient and the patient is able to continue with therapy. The other dermatoses where tacrolimus has been used include contact dermatitis, psoriasis and pyoderma gangrenosum.

Neuroimmune alterations in the complex regional pain syndrome

This review focuses on some clinical aspects of the complex regional pain syndrome, such as oedema, local temperature changes and chronic pain, as a result of supposed neurogenic inflammation. Involvement of the immune system could imply the subsequent release of neuropeptides, pro-inflammatory cytokines and eicosanoids, which in turn leads to a complex cross-talk of primary and secondary generated mediators of inflammation. The development and application of drugs that act through selective receptor antagonism or enzymatic synthesis inhibition to prevent further stimulation of this cascade that could inevitably lead to chronicity of this disease are extensively discussed.

Novel immunomodulators for topical skin disease therapy

The use of topical corticosteroids has revolutionised the treatment of inflammatory skin diseases. However, problems including pharmacological resistance, as well as the side effect profile of potent topical corticosteroids, has prompted studies to investigate into other topical non-corticosteroidal agents in inflammatory skin diseases. This review outlines the major types of inflammatory skin diseases and discusses emerging therapies based on topical immunosuppressive macrolide antibiotics. In particular, tacrolimus and ascomycin derivatives have been shown to be effective for treating atopic dermatitis with a surprising lack of side effects. It is expected that these agents will play an important role in future dermatological therapy. Accumulating evidence suggests the importance of lipid-derived mediators of inflammation (eicosanoids and platelet-activating factor) in cutaneous inflammatory diseases. The role of these mediators in skin inflammation is also addressed in this review. Though there appears to be a large amount of redundancy in the activities of these lipid mediators, this family of agents could potentially serve as targets for anti-inflammatory therapy. Inasmuch as the phospholipase A(2) family of enzymes serve to synthesise both eicosanoids and platelet-activating factor, inhibition at this step could have important therapeutic benefits in designing therapy for inflammatory skin diseases.

New drugs in the treatment of psoriasis

Psoriasis is one of the most common skin disorders affecting approximately 2% of the population; the disease is recurrent and can be very debilitating. The cause of psoriasis is unknown, although it appears to be an autoimmune disease with a genetic component to its aetiology. Past topical treatments such as emollients, coal tar and dithranol have been messy, cosmetically unacceptable or of low efficacy, while older systemic therapies have suffered from significant side effects. Newer drugs with better therapeutic indexes and new antiproliferative/immunomodulatory therapies based on an increased understanding of the origins of psoriasis have brought us closer to the goal of safely and efficaciously treating the disease. This review will cover the newest topical and systemic drugs currently in use, in clinical trials or preclinical development.