JAK-STAT Inhibitors in Atopic Dermatitis from Pathogenesis to Clinical Trials Results

Microorganisms - Tập 8 Số 11 - Trang 1743
Krzysztof Szalus1, Magdalena Trzeciak1, Roman Nowicki1
1Department of Dermatology, Venereology and Allergology, Medical University of Gdansk, 80-214 Gdańsk, Poland

Tóm tắt

A common disease worldwide is known as atopic dermatitis (AD), named also as atopic eczema, which is a chronic recurrent complex inflammatory skin disorder. It affects 2–10% of the adult population and up to 20% of the pediatric population. The clinical AD picture appears in typically localized eczema and dry skin, and is dominated by a persistent pruritus followed by sleep disturbances. AD strongly impacts on the quality of life of AD patients and their families as well as on social and economic aspects. The pathogenesis of the disease is complex and consists of multiple interactions between immunological disturbances, skin barrier defect, and microbial dysbiosis with environmental influences. The treatment of AD reflects the pathogenetic disorders, starting from basic emollient therapy, and goes to topical anti-inflammatory regimens followed by phototherapy, systemic immunosuppressive drugs, and new biologic immunomodulators. This paper will thus summarize the novel collection of biological treatment JAK-STAT inhibitors dedicated to AD.

Từ khóa


Tài liệu tham khảo

Czarnecka, 2019, Epidemiology of atopic dermatitis in Europe, J. Drug Assess., 8, 126, 10.1080/21556660.2019.1619570

Barbarot, 2018, Epidemiology of atopic dermatitis in adults: Results from an international survey, Allergy, 73, 1284, 10.1111/all.13401

Eichenfield, 2014, Guidelines of care for the management of atopic dermatitis: Section 1. Diagnosis and assessment of atopic dermatitis, J. Am. Acad. Dermatol., 70, 338, 10.1016/j.jaad.2013.10.010

Zaniboni, 2016, Skin barrier in atopic dermatitis: Beyond filaggrin, An. Bras. Dermatol., 91, 472, 10.1590/abd1806-4841.20164412

Palmer, 2006, Common loss-of-function variants of the epidermal barrier protein filaggrin are a major predisposing factor for atopic dermatitis, Nat Genet., 38, 441, 10.1038/ng1767

Weidinger, 2006, Loss-of-function variations within the filaggrin gene predispose for atopic dermatitis with allergic sensitizations, J. Allergy Clin. Immunol., 118, 214, 10.1016/j.jaci.2006.05.004

Trzeciak, 2017, Expression of Cornified Envelope Proteins in Skin and Its Relationship with Atopic Dermatitis Phenotype, Acta Derm Venereol., 97, 36, 10.2340/00015555-2482

Macheleidt, 2002, Deficiency of epidermal protein-bound omega-hydroxyceramides in atopic dermatitis, J. Ivestig. Dermatol., 119, 166, 10.1046/j.1523-1747.2002.01833.x

Elias, 2014, Mechanisms of abnormal lamellar body secretion and the dysfunctional skin barrier in atopic dermatitis, J. Allergy Clin. Immunol., 134, 781, 10.1016/j.jaci.2014.05.048

Wollenberg, 2009, Proactive therapy of atopic dermatitis–an emerging concept, Allergy, 64, 276, 10.1111/j.1398-9995.2008.01803.x

Simpson, 2006, Atopic dermatitis, Med. Clin. N. Am., 90, 149, 10.1016/j.mcna.2005.09.002

Agrawal, 2014, Skin Barrier Defects in Atopic Dermatitis, Curr. Allergy Asthma Rep., 14, 1, 10.1007/s11882-014-0433-9

Zvulunov, 2012, Barrier-restoring therapies in atopic dermatitis: Current approaches and future perspectives, Dermatol. Res. Pr., 2012, 1, 10.1155/2012/923134

Kong, 2012, Skin microbiome: Looking back to move forward, J. Investig. Dermatol., 132, 933, 10.1038/jid.2011.417

Kim, J.E., and Kim, H.S. (2019). Microbiome of the Skin and Gut in Atopic Dermatitis (AD): Understanding the Pathophysiology and Finding Novel Management Strategies. J. Clin. Med., 8.

Gilani, 2005, Staphylococcus aureus re-colonization in atopic dermatitis: Beyond the skin, Clin. Exp. Dermatol., 30, 10, 10.1111/j.1365-2230.2004.01679.x

Paller, 2019, The Microbiome in Patients with Atopic Dermatitis, J. Allergy Clin. Immunol., 143, 26, 10.1016/j.jaci.2018.11.015

Alexander, 2019, The role of bacterial skin infections in atopic dermatitis: Expert statement and review from the International Eczema Council Skin Infection Group, Br. J. Dermatol., 182, 1331, 10.1111/bjd.18643

Bieber, 2020, Targeting T2 Inflammation by Dupilumab Impacts on the Microbiomic “Ménage à Trois” of Atopic Dermatitis, J. Investig. Dermatol., 140, 15, 10.1016/j.jid.2019.07.680

Waldman, 2017, Atopic Dermatitis: Pathogenesis, Semin. Cutan. Med. Surg., 36, 3

Dhingra, 2013, Intrinsic atopic dermatitis shows similar TH2 and higher TH17 immune activation compared with extrinsic atopic dermatitis, J. Allergy Clin. Immunol., 132, 361, 10.1016/j.jaci.2013.04.046

Noda, 2015, The Asian atopic dermatitis phenotype combines features of atopic dermatitis and psoriasis with increased TH17 polarization, J. Allergy Clin. Immunol., 136, 1254, 10.1016/j.jaci.2015.08.015

Furue, 2018, Emerging role of interleukin-31 and interleukin-31 receptor in pruritus in atopic dermatitis, Allergy, 73, 29, 10.1111/all.13239

Brunner, 2017, The immunology of atopic dermatitis and its reversibility with broad-spectrum and targeted therapies, J. Allergy Clin. Immunol., 139, S65, 10.1016/j.jaci.2017.01.011

Kim, 2019, Pathophysiology of atopic dermatitis: Clinical implications, Allergy Asthma Proc., 40, 84, 10.2500/aap.2019.40.4202

Czarnowicki, 2019, Atopic dermatitis endotypes and implications for targeted therapeutics, J. Allergy Clin. Immunol., 143, 1, 10.1016/j.jaci.2018.10.032

Paller, 2016, Efficacy and safety of crisaborole ointment, a novel, nonsteroidal phosphodiesterase 4 (PDE4) inhibitor for the topical treatment of atopic dermatitis (AD) in children and adults, J. Am. Acad. Dermatol., 75, 494, 10.1016/j.jaad.2016.05.046

Olson, 2016, Vitamin D decreases STAT phosphorylation and inflammatory cytokine output in T-LGL leukemia, Cancer Biol. Ther., 18, 290, 10.1080/15384047.2016.1235669

Barberi, 2017, Vitamin D status and body mass index in children wih atopic dermatitis: A pilot study in Italian children, Immunol. Lett., 181, 31, 10.1016/j.imlet.2016.11.004

Howell, 2019, Targeting the Janus Kinase Family in Autoimmune Skin Diseases, Front. Immunol., 10, 2342, 10.3389/fimmu.2019.02342

Bao, 2013, The involvement of the JAK-STAT signaling pathway in chronic inflammatory skin disease atopic dermatitis, JAK-STAT, 2, e24137, 10.4161/jkst.24137

Leung, 2014, Deciphering the complexities of atopic dermatitis: Shifting paradigms in treatment approaches, J. Allergy Clin. Immunol., 134, 769, 10.1016/j.jaci.2014.08.008

He, 2018, JAK Inhibitors for Atopic Dermatitis: An Update, Am. J. Clin. Dermatol., 20, 181, 10.1007/s40257-018-0413-2

Montilla, 2019, Scoping Review on the Use of Drugs Targeting JAK/STAT Pathway in Atopic Dermatitis, Vitiligo, and Alopecia Areata, Dermatol. Ther., 9, 655, 10.1007/s13555-019-00329-y

Gooderham, 2019, Efficacy and Safety of Oral Janus Kinase 1 Inhibitor Abrocitinib for Patients With Atopic Dermatitis: A Phase 2 Randomized Clinical Trial, JAMA Dermatol., 155, 1371, 10.1001/jamadermatol.2019.2855

Silverberg, 2020, Efficacy and Safety of Abrocitinib in Patients with Moderate-to-Severe Atopic Dermatitis: A Randomized Clinical Trial, JAMA Dermatol., 156, 863, 10.1001/jamadermatol.2020.1406

Silverberg, 2019, Baricitinib in adult patients with moderate-to-severe atopic dermatitis: A phase 2 parallel, double-blinded, randomized placebo-controlled multiple-dose study, J. Am. Acad. Dermatol., 80, 913, 10.1016/j.jaad.2018.01.018

Simpson, 2020, Baricitinib in patients with moderate-to-severe atopic dermatitis and inadequate response to topical corticosteroids: Results from two randomized monotherapy phase III trials, Br. J. Dermatol., 183, 242, 10.1111/bjd.18898

Beck, 2018, Upadacitinib effect on pruritus in moderate-to-severe atopic dermatitis; from a phase 2b randomized, placebo-controlled trial, Ann. Allergy Asthma Immunol., 121, S21, 10.1016/j.anai.2018.09.063

Thaci, 2020, Upadacitinib in adults with moderate to severe atopic dermatitis: 16-week results from a randomized, placebo-controlled trial, J. Allergy Clin. Immunol., 145, 877, 10.1016/j.jaci.2019.11.025

Ghoreschi, 2011, Modulation of innate and adaptive immune responses by tofacitinib (CP-690,550), J. Immunol., 186, 4234, 10.4049/jimmunol.1003668

Kubo, 2013, The JAK inhibitor, tofacitinib, reduces the T cell stimulatory capacity of human monocyte-derived dendritic cells, Ann. Rheum. Dis., 73, 2192, 10.1136/annrheumdis-2013-203756

Levy, 2015, Treatment of recalcitrant atopic dermatitis with the oral Janus kinase inhibitor tofacitinib citrate, J. Am. Acad. Dermatol., 73, 395, 10.1016/j.jaad.2015.06.045

Bissonnette, 2016, Topical tofacitinib for atopic dermatitis: A phase IIa randomized trial, Br. J. Dermatol., 175, 902, 10.1111/bjd.14871

Nakagawa, 2018, Efficacy and safety of topical JTE-052, a Janus kinase inhibitor, in Japanese adult patients with moderate-to-severe atopic dermatitis: A phase II, multicentre, randomized, vehicle-controlled clinical study, Br. J. Dermatol., 178, 424, 10.1111/bjd.16014

Nakagawa, 2019, Phase 2 clinical study of delgocitinib ointment in pediatric patients with atopic dermatitis, J. Allergy Clin. Immunol., 144, 1575, 10.1016/j.jaci.2019.08.004

Nakagawa, 2020, Delgocitinib ointment, a topical Janus kinase inhibitor, in adult patients with moderate to severe atopic dermatitis: A phase 3, randomized, double-blind, vehicle-controlled study and an open-label, long-term extension study, J. Am. Acad. Dermatol., 82, 823, 10.1016/j.jaad.2019.12.015

Kim, 2020, Treatment of atopic dermatitis with ruxolitinib cream (JAK1/JAK2 inhibitor) or triamcinolone cream, J. Allergy Clin. Immunol., 145, 572, 10.1016/j.jaci.2019.08.042

Piscitelli, 2018, Cerdulatinib (DMVT-502), a novel, topical dual Janus kinase/spleen tyrosine kinase inhibitor, improves the cellular and molecular cutaneous signaure in patients with atopic dermatitis, Exp. Dermatol., 27, 44

Bissonnette, 2019, The oral Janus kinase/spleen tyrosine kinase inhibitor ASN002 demonstrates efficacy and improves associated systemic inflammation in patients with moderate-to-severe atopic dermatitis: Results from a randomized double-blind placebo-controlled study, Br. J. Dermatol., 181, 733, 10.1111/bjd.17932