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Cepica TB, Powers CM, Lu G, Thomas C. Utility of laboratory and blood pressure monitoring in patients with dermatologic disorders receiving cyclosporine. Arch Dermatol Res 2024; 316:461. [PMID: 38967793 DOI: 10.1007/s00403-024-03194-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Revised: 06/10/2024] [Accepted: 06/15/2024] [Indexed: 07/06/2024]
Affiliation(s)
- Tyler B Cepica
- Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, USA
| | - Camille M Powers
- Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, USA
| | - Grace Lu
- Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, USA
| | - Cristina Thomas
- Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, USA.
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, USA.
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2
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Rameshrad M, Naraki K, Memariani Z, Hosseinzadeh H. Protective effects of Panax ginseng as a medical food against chemical toxic agents: molecular and cellular mechanisms. NAUNYN-SCHMIEDEBERG'S ARCHIVES OF PHARMACOLOGY 2024:10.1007/s00210-024-03186-5. [PMID: 38861010 DOI: 10.1007/s00210-024-03186-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Accepted: 05/24/2024] [Indexed: 06/12/2024]
Abstract
Humans are exposed to different types of toxic agents, which may directly induce organ malfunction or indirectly alter gene expression, leading to carcinogenic and teratogenic effects, and eventually death. Ginseng (Panax ginseng) is the most valuable of all medicinal herbs. Nevertheless, specific data on the antidotal mechanisms of this golden herb are currently unavailable. Based on the findings of in vitro, in vivo, and clinical studies, this review focused on the probable protective mechanisms of ginseng and its major components, such as protopanaxadiols, protopanaxatriols, and pentacyclic ginsenosides against various chemical toxic agents. Relevant articles from 2000 to 2023 were gathered from PubMed/Medline, Scopus, and Google Scholar. This literature review shows that P. ginseng and its main components have protective and antidotal effects against the deteriorative effects of pesticides, pharmaceutical agents, including acetaminophen, doxorubicin, isoproterenol, cyclosporine A, tacrolimus, and gentamicin, ethanol, and some chemical agents. These improvements occur through multi-functional mechanisms. They exhibit antioxidant activity, induce anti-inflammatory action, and block intrinsic and extrinsic apoptotic pathways. However, relevant clinical trials are necessary to validate the mentioned effects and translate the knowledge from basic science to human benefit, fulfilling the fundamental goal of all toxicologists.
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Affiliation(s)
- Maryam Rameshrad
- Department of Pharmacodynamics and Toxicology, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Karim Naraki
- Department of Pharmacodynamics and Toxicology, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
- Student Research Committee, Mashhad University of Medical Science, Mashhad, Iran
| | - Zahra Memariani
- Traditional Medicine and History of Medical Sciences Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Hossein Hosseinzadeh
- Department of Pharmacodynamics and Toxicology, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran.
- Pharmaceutical Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran.
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3
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Woo YR, Choi A, Song SW, Kim S, Son SW, Cho SH, Kim S, Kim JE. Risk of Developing Hypertension in Atopic Dermatitis Patients Receiving Long-term and Low-dose Cyclosporine: A Nationwide Population-based Cohort Study. Ann Dermatol 2024; 36:112-119. [PMID: 38576249 PMCID: PMC10995617 DOI: 10.5021/ad.23.099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 11/09/2023] [Accepted: 11/14/2023] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND Cyclosporine (CS) is a first-line immunosuppressive agent used to manage moderate to severe atopic dermatitis (AD). To date, the risk of developing hypertension associated with the long-term use of low-dose CS in AD patients is understudied. OBJECTIVE To determine the cumulative dose-dependent effect of CS on the risk of developing hypertension in patients with AD. METHODS A nationwide population-based retrospective cohort with 1,844,009 AD patients was built from the Korean National Health Insurance System database from 2005 to 2009. A Cox proportional-hazard regression analysis was performed according to patients' CS treatment history adjusted for potential confounders. RESULTS Current use of CS was associated with an increased risk of developing hypertension (adjusted hazard ratio, 4.442; 95% confidence interval, 3.761-5.247). Among the current CS users, a higher cumulative dose of CS (≥39,725 mg) or longer cumulative use of CS (≥182 days), was significantly associated with an increased risk of developing hypertension. CONCLUSION The incidence of CS-associated hypertension is very low when using low-dose treatment regimens for AD. However, the current use or a high cumulative dose of CS for treating patients with AD increases the risk of developing hypertension. Precaution is needed when prescribing CS for long-term treatment of AD.
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Affiliation(s)
- Yu Ri Woo
- Department of Dermatology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Arum Choi
- Department of Preventive Medicine and Public Health, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Seo Won Song
- Department of Dermatology, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Suyeun Kim
- Department of Dermatology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Sang Wook Son
- Department of Dermatology, Korea University College of Medicine, Seoul, Korea
| | - Sang Hyun Cho
- Department of Dermatology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Sukil Kim
- Department of Preventive Medicine and Public Health, College of Medicine, The Catholic University of Korea, Seoul, Korea.
| | - Jung Eun Kim
- Department of Dermatology, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
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Caffarelli C, Giannetti A, Giannì G, Ricci G. Anti-inflammatory and biologic drugs for atopic dermatitis: a therapeutic approach in children and adolescents. Front Med (Lausanne) 2023; 10:1214963. [PMID: 37654660 PMCID: PMC10466416 DOI: 10.3389/fmed.2023.1214963] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Accepted: 07/27/2023] [Indexed: 09/02/2023] Open
Abstract
Atopic dermatitis (AD) is a chronic inflammatory disease with a heterogeneous pathogenesis correlated with dysregulation of the immune system and a prevalence of the T2-mediated immune pathway. Recent understanding of the pathogenesis of AD has allowed the development of new drugs targeting different mechanisms and cytokines that have changed the treatment approach. The aim of this review is to update knowledge on the standard of care and recent advancements in the control of skin inflammation. In light of recent guidelines, we report on the clinical efficacy of novel treatments, with special attention to situations where biologics and small molecules are involved.
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Affiliation(s)
- Carlo Caffarelli
- Clinica Pediatrica, Azienda Ospedaliero-Universitaria, Department of Medicine and Surgery, Università di Parma, Parma, Italy
| | - Arianna Giannetti
- Paediatrics Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Giuliana Giannì
- Clinica Pediatrica, Azienda Ospedaliero-Universitaria, Department of Medicine and Surgery, Università di Parma, Parma, Italy
| | - Giampaolo Ricci
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
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5
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Yang Y, Li YF, Hu K, Zhang SJ, Cui JF, Huang XT, He SM, Wang DD, Chen X. The Dosage Recommendation of Cyclosporin in Children with Hemophagocytic Lymphohistiocytosis based on Population Pharmacokinetic Model. Curr Pharm Des 2023; 29:2996-3004. [PMID: 38062660 DOI: 10.2174/0113816128286290231124055116] [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: 10/09/2023] [Accepted: 11/02/2023] [Indexed: 01/05/2024]
Abstract
OBJECTIVES Cyclosporin is one of the therapeutic regimens for hemophagocytic lymphohistiocytosis (HLH); however, the optimal dosage of cyclosporine in children with HLH is unknown. It has been found that piperacillin-tazobactam affects the cyclosporine pharmacokinetic process in pediatric HLH patients. Thus, the purpose of the present study was to recommend cyclosporin dosage for pediatric HLH with and without piperacillin- tazobactam. METHODS A previously established cyclosporine population pharmacokinetic model for pediatric HLH patients has been used in this study to recommend optimal dosage based on Monte Carlo simulation. The pediatric HLH patients have been included in eight weight groups (5, 10, 20, 30, 40, 50, 60, 70 kg) for sixteen dosages (1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16 mg/kg), split into one dose or two doses. RESULTS The optimal cyclosporin dosages for children having HLH without piperacillin-tazobactam have been found to be 15, 13, 12, 11, 10, and 9 mg/kg, split into two doses for weights of 5-7, 7-10, 10-20, 20-28, 28-45, and 45-70 kg, respectively. For children with HLH, optimal cyclosporin dosages with piperacillin-tazobactam have been found to be 8 and 7 mg/kg, split into two doses for weights of 5-20 and 20-70 kg, respectively. CONCLUSION It is the first time that the cyclosporin dosage regimens for HLH in children have been developed based on Monte Carlo simulation, and the initial dosage optimizations of cyclosporine in pediatric HLH patients have been recommended.
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Grants
- CJ20229030,CJ20229030 Changzhou Science and Technology Bureau
- Jiangsu Provincial Commission of Health and Family Planning
- RC20552111,RC20552222,KC23114,XYRHCX2022005,XYRHCX2021011,RC20552111,RC20552222,XYRHCX2022005,KC23114,XYRHCX2021011 Xuzhou Medical University
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Affiliation(s)
- Yang Yang
- Department of Pharmacy, The Affiliated Changzhou Children's Hospital of Nantong University, Changzhou, Jiangsu 213003, China
| | - Ya-Feng Li
- Department of Pharmacy, Feng Xian People's Hospital, Xuzhou, Jiangsu 221700, China
| | - Ke Hu
- Jiangsu Key Laboratory of New Drug Research and Clinical Pharmacy, School of Pharmacy, Xuzhou Medical University, Xuzhou, Jiangsu 221004, China
| | - Shi-Jia Zhang
- Jiangsu Key Laboratory of New Drug Research and Clinical Pharmacy, School of Pharmacy, Xuzhou Medical University, Xuzhou, Jiangsu 221004, China
| | - Jia-Fang Cui
- Jiangsu Key Laboratory of New Drug Research and Clinical Pharmacy, School of Pharmacy, Xuzhou Medical University, Xuzhou, Jiangsu 221004, China
| | - Xue-Ting Huang
- Jiangsu Key Laboratory of New Drug Research and Clinical Pharmacy, School of Pharmacy, Xuzhou Medical University, Xuzhou, Jiangsu 221004, China
| | - Su-Mei He
- Department of Pharmacy, Suzhou Hospital, Affiliated Hospital of Medical School, Nanjing University, Suzhou, Jiangsu 215153, China
| | - Dong-Dong Wang
- Jiangsu Key Laboratory of New Drug Research and Clinical Pharmacy, School of Pharmacy, Xuzhou Medical University, Xuzhou, Jiangsu 221004, China
| | - Xiao Chen
- School of Nursing, Xuzhou Medical University, Xuzhou, Jiangsu 221004, China
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Chojnacka-Purpurowicz J, Wygonowska E, Placek W, Owczarczyk-Saczonek A. Cyclosporine-induced gingival overgrowth-Review. Dermatol Ther 2022; 35:e15912. [PMID: 36208445 DOI: 10.1111/dth.15912] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 09/17/2022] [Accepted: 10/06/2022] [Indexed: 11/29/2022]
Abstract
Drug-induced gingival overgrowth (DIGO) is an undesirable effect resulting from the therapy of one of the three groups of drugs: phenytoin, calcium channel blockers, and cyclosporine A (CsA). It is caused by a fibrous overgrowth leading to gingivitis, periodontitis, and even tooth loss. Possible consequences include tooth decay worsening, pain and difficulty in eating, bleeding gums, and bad breath. The pathomechanism of the hypertrophy is unknown, but there is a correlation between insufficient oral hygiene and the severity of this phenomenon. The gender and age predilection of gingival hyperplasia as a result of CsA therapy is also noticeable. It is most common in children and adolescents of the male sex. The beneficial effect of the removal of tartar and local irritants in reducing the above symptoms has been demonstrated. One of the treatments for DIGO is conventional gingivectomy. The paper is a review article about cyclosporine-induced gingival hyperplasia.
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Affiliation(s)
- Joanna Chojnacka-Purpurowicz
- Department of Dermatology, Sexually Transmitted Diseases and Clinical Immunology, The University of Warmia and Mazury, Olsztyn, Poland
| | - Ewa Wygonowska
- Department of Dermatology, Sexually Transmitted Diseases and Clinical Immunology, The University of Warmia and Mazury, Olsztyn, Poland
| | - Waldemar Placek
- Department of Dermatology, Sexually Transmitted Diseases and Clinical Immunology, The University of Warmia and Mazury, Olsztyn, Poland
| | - Agnieszka Owczarczyk-Saczonek
- Department of Dermatology, Sexually Transmitted Diseases and Clinical Immunology, The University of Warmia and Mazury, Olsztyn, Poland
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Quantifying Physician Preferences for Systemic Atopic Dermatitis Treatments Using a Discrete-Choice Experiment. Dermatol Ther (Heidelb) 2022; 12:1197-1210. [PMID: 35445962 PMCID: PMC9022060 DOI: 10.1007/s13555-022-00723-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 03/30/2022] [Indexed: 11/04/2022] Open
Abstract
Introduction As research continues, new drugs will no doubt be added to the current pool of treatments for moderate-to-severe atopic dermatitis (AD). This raises the need for studies to determine prescriber preferences for different pharmacological options and the factors that influence their choice of treatment. Here we aim to explore physician preferences in the systemic treatment of moderate-to-severe AD, identify the sociodemographic characteristics that can influence physician preferences, and evaluate their satisfaction with current AD therapies. Methods A discrete-choice experiment (DCE) survey was administered to physicians treating patients with AD in Spain. Results were analyzed using a conditional logit model to estimate the relative importance of each attribute and the maximum risk accepted to achieve therapeutic benefit. Results A total of 28 respondents completed the DCE survey (67.9% female, mean age 45.9 years). Participants identified objective clinical efficacy and risk of severe adverse events (AEs) as the most important attributes, followed by improvement in sleep and pruritus and faster onset of action from the start of the treatment. Respondents gave less importance to mode of administration and therapeutic benefit in other atopic conditions. Respondents were willing to accept an increased risk of severe AEs and mild-to-moderate AEs leading to treatment discontinuation due to intolerance in order to obtain improvements in efficacy, sleep, and pruritus, and long-term clinical benefit. Conclusion Our findings can help prescribers choose the most appropriate systemic AD therapy. Supplementary Information The online version contains supplementary material available at 10.1007/s13555-022-00723-z.
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Binkhathlan Z, Alomrani AH, Hoxha O, Ali R, Kalam MA, Alshamsan A. Development and Characterization of PEGylated Fatty Acid- Block-Poly(ε-caprolactone) Novel Block Copolymers and Their Self-Assembled Nanostructures for Ocular Delivery of Cyclosporine A. Polymers (Basel) 2022; 14:polym14091635. [PMID: 35566805 PMCID: PMC9101097 DOI: 10.3390/polym14091635] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 04/09/2022] [Accepted: 04/14/2022] [Indexed: 12/10/2022] Open
Abstract
Low aqueous solubility and membrane permeability of some drugs are considered major limitations for their use in clinical practice. Polymeric micelles are one of the potential nano-drug delivery systems that were found to ameliorate the low aqueous solubility of hydrophobic drugs. The main objective of this study was to develop and characterize a novel copolymer based on poly (ethylene glycol) stearate (Myrj™)-block-poly(ε-caprolactone) (Myrj-b-PCL) and evaluate its potential as a nanosystem for ocular delivery of cyclosporine A (CyA). Myrj-b-PCL copolymer with various PCL/Myrj ratios were synthesized via ring-opening bulk polymerization of ε-caprolactone using Myrj (Myrj S40 or Myrj S100), as initiators and stannous octoate as a catalyst. The synthesized copolymers were characterized using 1H NMR, GPC, FTIR, XRD, and DSC. The co-solvent evaporation method was used to prepare CyA-loaded Myrj-b-PCL micelles. The prepared micelles were characterized for their size, polydispersity, and CMC using the dynamic light scattering (DLS) technique. The results from the spectroscopic and thermal analyses confirmed the successful synthesis of the copolymers. Transmission electron microscopy (TEM) images of the prepared micelles showed spherical shapes with diameters in the nano range (<200 nm). Ex vivo corneal permeation study showed sustained release of CyA from the developed Myrj S100-b-PCL micelles. In vivo ocular irritation study (Draize test) showed that CyA-loaded Myrj S100-b-PCL88 was well tolerated in the rabbit eye. Our results point to a great potential of Myrj S100-b-PCL as an ocular drug delivery system.
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Affiliation(s)
- Ziyad Binkhathlan
- Department of Pharmaceutics, College of Pharmacy, King Saud University, P.O. Box 2457, Riyadh 11451, Saudi Arabia; (A.H.A.); (O.H.); (R.A.); (M.A.K.); (A.A.)
- Nanobiotechnology Research Unit, College of Pharmacy, King Saud University, P.O. Box 2457, Riyadh 11451, Saudi Arabia
- Correspondence:
| | - Abdullah H. Alomrani
- Department of Pharmaceutics, College of Pharmacy, King Saud University, P.O. Box 2457, Riyadh 11451, Saudi Arabia; (A.H.A.); (O.H.); (R.A.); (M.A.K.); (A.A.)
- Nanobiotechnology Research Unit, College of Pharmacy, King Saud University, P.O. Box 2457, Riyadh 11451, Saudi Arabia
| | - Olsi Hoxha
- Department of Pharmaceutics, College of Pharmacy, King Saud University, P.O. Box 2457, Riyadh 11451, Saudi Arabia; (A.H.A.); (O.H.); (R.A.); (M.A.K.); (A.A.)
| | - Raisuddin Ali
- Department of Pharmaceutics, College of Pharmacy, King Saud University, P.O. Box 2457, Riyadh 11451, Saudi Arabia; (A.H.A.); (O.H.); (R.A.); (M.A.K.); (A.A.)
- Nanobiotechnology Research Unit, College of Pharmacy, King Saud University, P.O. Box 2457, Riyadh 11451, Saudi Arabia
| | - Mohd Abul Kalam
- Department of Pharmaceutics, College of Pharmacy, King Saud University, P.O. Box 2457, Riyadh 11451, Saudi Arabia; (A.H.A.); (O.H.); (R.A.); (M.A.K.); (A.A.)
- Nanobiotechnology Research Unit, College of Pharmacy, King Saud University, P.O. Box 2457, Riyadh 11451, Saudi Arabia
| | - Aws Alshamsan
- Department of Pharmaceutics, College of Pharmacy, King Saud University, P.O. Box 2457, Riyadh 11451, Saudi Arabia; (A.H.A.); (O.H.); (R.A.); (M.A.K.); (A.A.)
- Nanobiotechnology Research Unit, College of Pharmacy, King Saud University, P.O. Box 2457, Riyadh 11451, Saudi Arabia
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Sadeghi S, Kalantari Y, Seirafianpour F, Goodarzi A. The Efficacy and Safety of Topical Cyclosporine-A in Dermatology: A Systematic Review. Dermatol Ther 2022; 35:e15490. [PMID: 35384191 DOI: 10.1111/dth.15490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 03/24/2022] [Accepted: 03/26/2022] [Indexed: 11/29/2022]
Abstract
Cyclosporine-A (Cyc-A) was initially prescribed as systemic therapy for patients receiving solid organ transplants or in patients with graft versus host disease (GVHD). Topical Cyc-A is an ideal form of Cyclosporine in the treatment of mucocutaneous disorders as it causes fewer systemic side effects and has more stable results than steroids; however, poor absorption through the skin makes the development of new formulations necessary to improve skin permeability. To evaluate the efficacy and safety of topical Cyc-A in different dermatological conditions. A thorough systematic review was performed on PubMed/Medline, Embase, Scopus, and Web of Science databases as well as Google Scholar, and relevant studies from 2000 until January 3rd, 2022, were selected. The study was conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA). Topical Cyc-A was observed to be an effective medication in the treatment of oral lichen planus, psoriasis, burning mouth syndrome, Pyoderma Gangrenosum, and Zoon's balanitis. Adverse side effects such as dysphagia, burning sensation, lips swealing, and gastrointestinal upset were reported following Cyc-A mouthwash use, whereas mild erythema, dryness, and fissuring of the skin were observed following the Cyc-A lipogel application. Topical Cyc-A was found to be a good alternative to traditional treatment regimens for immune-mediated mucocutaneous conditions. Cyc-A can be considered as a safe and efficient option in cases of long-term treatment as it does not have the same adverse effects of long-term steroids. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Sara Sadeghi
- Rasool Akram Medical Complex Clinical Research Development Center (RCRDC), Iran University of Medical Sciences, Tehran, Iran
| | - Yasamin Kalantari
- Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran.,Autoimmune Bullous Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Farnoosh Seirafianpour
- Student Research Committee, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Azadeh Goodarzi
- Department of Dermatology, Faculty of Dermatology, Rasool Akram Medical Complex Clinical Research Development Center (RCRDC), School of Medicine, Iran University of Medical Sciences, Tehran, Iran.,Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Iran Jordan Dermatology and Hair Transplantation Center, Tehran, Iran
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Labib A, Ju T, Vander Does A, Yosipovitch G. Immunotargets and Therapy for Prurigo Nodularis. Immunotargets Ther 2022; 11:11-21. [PMID: 35502157 PMCID: PMC9056055 DOI: 10.2147/itt.s316602] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Accepted: 04/08/2022] [Indexed: 12/18/2022] Open
Abstract
Prurigo nodularis is a chronic inflammatory skin disease consisting of severely pruritic nodules that can be very debilitating for patients. The basis of this skin condition is immunological dysregulation and neural amplification, driven by T-lymphocytes, mast cells, eosinophilic granulocytes, macrophages, and cytokines mediating itchy processes. Further complicating this already taxing diagnosis is the lack of approved treatment and consensus on management; although there are off-label treatments utilized as therapy. Immunomodulators are the cornerstone of treatment for PN, and additional novel therapies targeting key players in the immunological cascade are currently undergoing investigation. In this review, we will highlight targets of the immune cascade and explore current immunomodulating treatments as well as immunotherapies on the horizon for the management of prurigo nodularis.
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Affiliation(s)
- Angelina Labib
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery and Miami Itch Center, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Teresa Ju
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery and Miami Itch Center, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Ashley Vander Does
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery and Miami Itch Center, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Gil Yosipovitch
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery and Miami Itch Center, University of Miami Miller School of Medicine, Miami, FL, USA
- Correspondence: Gil Yosipovitch, Dr Phillip Frost Department of Dermatology and Cutaneous Surgery and Miami Itch Center, University of Miami Miller School of Medicine, 1600 NW 10th Ave RMSB Building 2067B, Miami, FL, USA, Tel +1 305 213-5824, Email
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11
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Karamova AE, Chikin VV, Kubanov AA, Davletbaeva LK. Long-wavelength ultraviolet A (UVA-1) phototherapy for the treatment of patients with atopic dermatitis. VESTNIK DERMATOLOGII I VENEROLOGII 2021. [DOI: 10.25208/vdv1286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
One of the methods of therapy for atopic dermatitis is long-wavelength ultraviolet therapy A (UVA-1- therapy). This review aims to provide the mechanisms of action of UVA-1-therapy an overview about the effectiveness of UVA-1-therapy in patients with atopic dermatitis taking into account factors that can affect the effectiveness of treatment radiation dose, skin phototype of patients, concomitant drug therapy. The available data on a decrease in the severity of atopic dermatitis as a result of the course of UVA-1-therapy and on a decrease in the severity of itching in patients are presented. The data on the rate of onset of the therapeutic effect of UVA-1-therapy and the duration of its maintenance are considered. The safety of UVA-1-therapy is discussed, and the most frequent undesirable effects a feeling of warmth, fever, itching, hyperpigmentation, are given. The possibility of developing side effects requiring discontinuation of treatment is assessed. The data obtained indicate the effectiveness and safety of the UFA-1-radiation in the treatment of patients with moderate-to-severe atopic dermatitis.
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Costanzo A, Amerio P, Asero R, Chiricozzi A, Corazza M, Cristaudo A, Cusano F, Ferrucci SM, Nettis E, Patrizi A, Patruno C, Peris K, Picozza M, Stingeni L, Girolomoni G. Long-term management of moderate-to-severe adult atopic dermatitis: a consensus by the Italian Society of Dermatology and Venereology (SIDeMaST), the Association of Italian Territorial and Hospital Allergists and Immunologists (AAIITO ), the Italian Association of Hospital Dermatologists (ADOI), the Italian Society of Allergological, Environmental and Occupational Dermatology (SIDAPA), and the Italian Society of Allergy, Asthma and Clinical Immunology (SIAAIC). Ital J Dermatol Venerol 2021; 157:1-12. [PMID: 34929995 DOI: 10.23736/s2784-8671.21.07129-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Atopic dermatitis (AD) is a common chronic-relapsing inflammatory skin disease, burdened by various comorbidities. AD most commonly occurs in children but may persist or present in adulthood becoming a lifelong condition. Therefore, AD requires an effective long-term treatment improving disease signs and symptoms but also of patients' quality of life (QoL). However continuous long-term use of most traditional AD immunosuppressive treatments is not recommended for safety reasons or insufficient efficacy data. Despite the available guidelines, there is still need for knowledge of AD long-term treatment, taking into account new disease measures and recent treatment options. Five Italian scientific societies implemented a joint consensus procedure to define the most appropriate clinical practice for the long-term management of adult moderate-severe AD. Through a modified Delphi procedure, consensus was reached by overall 51 Italian dermatologists and allergists (The Italian AD Study Group) experienced in the management of adult AD on 14 statements covering three AD areas of interest, namely diagnosis, definition of disease severity and clinimetrics, and a treat-to-target approach. This paper reports and discusses the agreed statements, which define disease and patient impact measures, therapeutic approach, and a treatment decision algorithm to support clinicians in the long-term management of adult patients with moderate-to-severe AD in their daily clinical practice.
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Affiliation(s)
- Antonio Costanzo
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.,Unit of Dermatology, IRCCS Humanitas Clinic, Rozzano, Milan, Italy
| | - Paolo Amerio
- Unit of Dermatology, Department of Medicine and Aging Science, G. D'Annunzio University, Chieti, Chieti-Pescara, Italy
| | - Riccardo Asero
- Department of Allergology, San Carlo Clinic, Paderno Dugnano, Milan, Italy
| | - Andrea Chiricozzi
- Unit of Dermatology, Department of Surgical and Medical Sciences, IRCCS A. Gemelli University Polyclinic Foundation, Rome, Italy.,Unit of Dermatology, Department of Medicine and Translational Surgery, Sacred Heart Catholic University, Rome, Italy
| | - Monica Corazza
- Section of Dermatology, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Antonio Cristaudo
- Department of Dermatology, IRCCS San Gallicano Dermatological Institute, Rome, Italy
| | - Francesco Cusano
- Unit of Dermatology, San Pio Hospital - G. Rummo Hospital, Benevento, Italy
| | - Silvia M Ferrucci
- Section of Dermatology, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Eustachio Nettis
- Department of Emergency and Organ Transplantation, School and Chair of Allergology and Clinical Immunology, Aldo Moro University, Bari, Italy
| | - Annalisa Patrizi
- Dermatology of Department of Specialistic, Diagnostic and Experimental Medicine (DIMES), Alma Mater Studiorum, University of Bologna, Bologna, Italy - .,Unit of Dermatology, IRCCS S. Orsola-Malpighi Polyclinic, Bologna, Italy
| | - Cataldo Patruno
- Department of Health Sciences, Magna Grecia University, Catanzaro, Italy
| | - Ketty Peris
- Unit of Dermatology, Department of Surgical and Medical Sciences, IRCCS A. Gemelli University Polyclinic Foundation, Rome, Italy.,Unit of Dermatology, Department of Medicine and Translational Surgery, Sacred Heart Catholic University, Rome, Italy
| | - Mario Picozza
- National Association of Atopic Dermatitis (ANDeA), Prato, Italy
| | - Luca Stingeni
- Section of Dermatology, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Giampiero Girolomoni
- Section of Dermatology, Department of Medicine, University of Verona, Verona, Italy
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Bhanja DB, Sil A, Panigrahi A, Biswas SK. Cyclosporine-induced acrofacial hyperpigmentation: report of a rare occurrence and review of the literature. Int J Dermatol 2021; 61:e180-e182. [PMID: 34258763 DOI: 10.1111/ijd.15801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 05/22/2021] [Accepted: 07/01/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Dibyendu B Bhanja
- Department of Dermatology, Venereology, and Leprosy, Midnapore Medical College and Hospital, West Bengal, India
| | - Abheek Sil
- Department of Dermatology, Venereology, and Leprosy, RG Kar Medical College and Hospital, Kolkata, West Bengal, India
| | - Avik Panigrahi
- Department of Dermatology, Venereology, and Leprosy, RG Kar Medical College and Hospital, Kolkata, West Bengal, India
| | - Surajit K Biswas
- Department of Dermatology, Venereology, and Leprosy, RG Kar Medical College and Hospital, Kolkata, West Bengal, India
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14
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Trombino S, Curcio F, Poerio T, Pellegrino M, Russo R, Cassano R. Chitosan Membranes Filled with Cyclosporine A as Possible Devices for Local Administration of Drugs in the Treatment of Breast Cancer. Molecules 2021; 26:molecules26071889. [PMID: 33810514 PMCID: PMC8036521 DOI: 10.3390/molecules26071889] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 03/19/2021] [Accepted: 03/23/2021] [Indexed: 01/12/2023] Open
Abstract
The aim of this work is the design, preparation and characterization of membranes based on cyclosporine A (CsA) and chitosan carboxylate (CC) to be used as an implantable subcutaneous medical device for a prolonged therapeutic effect in the treatment of breast cancer. The choice to use CsA is due to literature data that have demonstrated its possible antitumor activity on different types of neoplastic cells. To this end, CsA was bound to CC through an amidation reaction to obtain a prodrug to be dispersed in a chitosan-based polymeric membrane. The reaction intermediates and the final product were characterized by Fourier transform infrared spectroscopy (FT-IR) and proton nuclear magnetic resonance (1H-NMR). Membranes were analyzed by differential scanning calorimetry (DSC) and scanning electron microscopy (SEM). The data obtained showed the effective formation of the amide bond between CsA and CC and the complete dispersion of CsA inside the polymeric membrane. Furthermore, preliminary tests, conducted on MDA-MB-231, a type of breast cancer cell line, have shown a high reduction in the proliferation of cancer cells. These results indicate the possibility of using the obtained membranes as an interesting strategy for the release of cyclosporin-A in breast cancer patients.
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Affiliation(s)
- Sonia Trombino
- Department of Pharmacy and Health and Nutrition Sciences, University of Calabria, Arcavacata di Rende, 87036 Cosenza, Italy; (S.T.); (F.C.); (M.P.); (R.R.)
| | - Federica Curcio
- Department of Pharmacy and Health and Nutrition Sciences, University of Calabria, Arcavacata di Rende, 87036 Cosenza, Italy; (S.T.); (F.C.); (M.P.); (R.R.)
| | - Teresa Poerio
- Institute on Membrane Technology (CNR-ITM), University of Calabria, Arcavacata di Rende, 87036 Cosenza, Italy;
| | - Michele Pellegrino
- Department of Pharmacy and Health and Nutrition Sciences, University of Calabria, Arcavacata di Rende, 87036 Cosenza, Italy; (S.T.); (F.C.); (M.P.); (R.R.)
| | - Rossella Russo
- Department of Pharmacy and Health and Nutrition Sciences, University of Calabria, Arcavacata di Rende, 87036 Cosenza, Italy; (S.T.); (F.C.); (M.P.); (R.R.)
| | - Roberta Cassano
- Department of Pharmacy and Health and Nutrition Sciences, University of Calabria, Arcavacata di Rende, 87036 Cosenza, Italy; (S.T.); (F.C.); (M.P.); (R.R.)
- Correspondence: ; Tel.: +39-984-493227
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