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Wang M, Gao XH, Zhang L. A Review of Dupilumab in the Treatment of Atopic Dermatitis in Infants and Children. Drug Des Devel Ther 2024; 18:941-951. [PMID: 38560522 PMCID: PMC10981892 DOI: 10.2147/dddt.s457761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 03/18/2024] [Indexed: 04/04/2024] Open
Abstract
Atopic dermatitis (AD), a common pruritic and chronic inflammatory skin disease, has a major impact on a patient's quality of life. It is characterized by dry, itchy, and eczema-like rashes. AD is more prevalent in young children and has been linked to a variety of other allergy disorders. Traditional drug therapy has certain limitations for treating young children with AD. However, biologics have good clinical application prospects in the medical treatment of young patients. Dupilumab, a fully human monoclonal antibody, specifically binds to the IL-4 Rα subunit, inhibiting IL-4 and IL-13 signaling and blocking the occurrence of type 2 inflammatory response. It has a good effect on treating infants and children with moderate-to-severe AD. This review explores the safety and efficacy of dupilumab in the treatment of AD in infants and children and the impact of early intervention on AD progression, with the aim of informing clinical practice in the use of dupilumab for the treatment of young patients with AD.
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Affiliation(s)
- Mingyue Wang
- Department of Dermatology, the First Hospital of China Medical University, Shenyang, 110001, People’s Republic of China
- NHC Key Laboratory of Immunodermatology, China Medical University, Shenyang, People’s Republic of China
- Key Laboratory of Immunodermatology, China Medical University, Ministry of Education, Shenyang, People’s Republic of China
- National and Local Joint Engineering Research Center of Immunodermatological Theranostics, Shenyang, People’s Republic of China
| | - Xing-Hua Gao
- Department of Dermatology, the First Hospital of China Medical University, Shenyang, 110001, People’s Republic of China
- NHC Key Laboratory of Immunodermatology, China Medical University, Shenyang, People’s Republic of China
- Key Laboratory of Immunodermatology, China Medical University, Ministry of Education, Shenyang, People’s Republic of China
- National and Local Joint Engineering Research Center of Immunodermatological Theranostics, Shenyang, People’s Republic of China
| | - Li Zhang
- Department of Dermatology, the First Hospital of China Medical University, Shenyang, 110001, People’s Republic of China
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Diaz-Cabrera NM, Bauman BM, Iro MA, Dabbah-Krancher G, Molho-Pessach V, Zlotogorski A, Shamriz O, Dinur-Schejter Y, Sharon TD, Stepensky P, Tal Y, Eisenstein EM, Pietzsch L, Schuetz C, Abreu D, Coughlin CC, Cooper MA, Milner JD, Williams A, Armoni-Weiss G, Snow AL, Leiding JW. Management of Atopy with Dupilumab and Omalizumab in CADINS Disease. J Clin Immunol 2024; 44:48. [PMID: 38231347 DOI: 10.1007/s10875-023-01636-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 12/02/2023] [Indexed: 01/18/2024]
Abstract
The caspase activation and recruitment domain 11 (CARD11) gene encodes a scaffold protein required for lymphocyte antigen receptor signaling. Dominant-negative, loss-of-function (LOF) pathogenic variants in CARD11 result in CARD11-associated atopy with dominant interference of NF-κB signaling (CADINS) disease. Patients with CADINS suffer with severe atopic manifestations including atopic dermatitis, food allergy, and chronic spontaneous urticaria in addition to recurrent infections and autoimmunity. We assessed the response of dupilumab in five patients and omalizumab in one patient with CADINS for the treatment of severe atopic symptoms. CARD11 mutations were validated for pathogenicity using a T cell transfection assay to assess the impact on activation-induced signaling to NF-κB. Three children and three adults with dominant-negative CARD11 LOF mutations were included. All developed atopic disease in infancy or early childhood. In five patients, atopic dermatitis was severe and recalcitrant to standard topical and systemic medications; one adult suffered from chronic spontaneous urticaria. Subcutaneous dupilumab was initiated to treat atopic dermatitis and omalizumab to treat chronic spontaneous urticaria. All six patients had rapid and sustained improvement in atopic symptoms with no complications during the follow-up period. Previous medications used to treat atopy were able to be decreased or discontinued. In conclusion, treatment with dupilumab and omalizumab for severe, refractory atopic disease in patients with CADINS appears to be effective and well tolerated in patients with CADINS with severe atopy.
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Affiliation(s)
- Natalie M Diaz-Cabrera
- Division of Allergy and Immunology, Department of Internal Medicine, University of South Florida College of Medicine, Tampa, FL, USA
| | - Bradly M Bauman
- Department of Pharmacology and Molecular Therapeutics, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, C-2013, Bethesda, MD, 20814, USA
- The Henry M. Jackson Foundation, Bethesda, MD, USA
| | - Mildred A Iro
- Faculty of Medicine and Institute for Life Sciences, University of Southampton, Southampton, UK
| | - Gina Dabbah-Krancher
- Department of Pharmacology and Molecular Therapeutics, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, C-2013, Bethesda, MD, 20814, USA
- The Henry M. Jackson Foundation, Bethesda, MD, USA
| | - Vered Molho-Pessach
- Pediatric Dermatology Service, Department of Dermatology and Venereology, The Faculty of Medicine, Hadassah Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel
- Department of Dermatology and Venereology, The Faculty of Medicine, Hadassah Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Abraham Zlotogorski
- Department of Dermatology and Venereology, The Faculty of Medicine, Hadassah Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Oded Shamriz
- Clinical Immunology and Allergy Unit, Department of Medicine, The Faculty of Medicine, Hadassah Medical Organization, Hebrew University of Jerusalem, Jerusalem, Israel
- The Lautenberg Center for Immunology and Cancer Research, The Faculty of Medicine, Institute of Medical Research Israel-Canada, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Yael Dinur-Schejter
- Department of Bone Marrow Transplantation and Cancer Immunotherapy, The Faculty of Medicine, Hebrew University of Jerusalem, Hadassah Medical Center, Jerusalem, Israel
| | - Tatyana Dubnikov Sharon
- Clinical Immunology and Allergy Unit, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Polina Stepensky
- Department of Bone Marrow Transplantation and Cancer Immunotherapy, The Faculty of Medicine, Hebrew University of Jerusalem, Hadassah Medical Center, Jerusalem, Israel
| | - Yuval Tal
- Clinical Immunology and Allergy Unit, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Eli M Eisenstein
- Department of Pediatrics, Hadassah-Hebrew University Medical Center, Mount Scopus, Jerusalem, Israel
| | - Leonora Pietzsch
- Department of Pediatrics, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Catharina Schuetz
- Department of Pediatrics, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
- UniversitätsCentrum Für Seltene Erkrankungen, Medizinische Fakultät Carl-Gustav-Carus, Technische Universität Dresden, Dresden, Germany
| | - Damien Abreu
- Division of Dermatology, Department of Medicine, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Carrie C Coughlin
- Division of Dermatology, Departments of Medicine & Pediatrics, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Megan A Cooper
- Division of Rheumatology/Immunology, Department of Pediatrics, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Joshua D Milner
- Department of Pediatrics, Columbia University Irving Medical Center, New York, NY, USA
| | - Anthony Williams
- Faculty of Medicine and Institute for Life Sciences, University of Southampton, Southampton, UK
| | - Gil Armoni-Weiss
- Department of Dermatology and Venereology, The Faculty of Medicine, Hadassah Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Andrew L Snow
- Department of Pharmacology and Molecular Therapeutics, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, C-2013, Bethesda, MD, 20814, USA.
| | - Jennifer W Leiding
- Division of Allergy and Immunology, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD, USA.
- Institute for Clinical and Translational Research, Johns Hopkins All Childrens Hospital, 600 Fifth Street South, Suite 3200, St. Petersburg, FL, 33701, USA.
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Anti-Inflammatory Effects Exerted by 14-Methoxyalternate C from Antarctic Fungal Strain Pleosporales sp. SF-7343 via the Regulation of NF-κB and JAK2/STAT3 in HaCaT Human Keratinocytes. Int J Mol Sci 2022; 23:ijms232314642. [PMID: 36498968 PMCID: PMC9740060 DOI: 10.3390/ijms232314642] [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: 10/21/2022] [Revised: 11/18/2022] [Accepted: 11/20/2022] [Indexed: 11/25/2022] Open
Abstract
Atopic dermatitis (AD) is a chronic inflammatory skin disease with a profound negative impact on patients' quality of life. Four known secondary fungal metabolites were found in the chemical study of the Antarctic fungus Pleosporales sp. SF-7343, including 14-methoxyalternate C (1), 5'-methoxy-6-methyl-biphenyl-3,4,3'-triol (2), 3,8,10-trihydroxy-4-methoxy-6-methylbenzocoumarin (3), and alternariol monomethyl ether (4). Additionally, we identified the skin anti-inflammatory composition from the SF-7343 strain. Interleukin-8 and -6 Screening results showed that compound 1 inhibited IL-8 and IL-6 in tumor necrosis factor-α/interferon-γ stimulated HaCaT cells. Compound 1 showed inhibitory effects on MDC and RANTES. It also downregulated the expression of intercellular adhesion molecule-1 (ICAM-1) and upregulated the expression of involucrin. The results of the mechanistic study showed that compound 1 inhibited the nuclear translocation of nuclear factor-kappa B p65 and STAT3. In conclusion, this study demonstrates the potential of the Antarctic fungal strain SF-7343 as a bioactive resource to inhibit skin inflammation, such as AD.
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